[Anastomosis of the small intestine in a septic medium protected by a trellis of vicryl].
An experimental study was carried out in rats to evaluate the outcome of small bowel anastomoses in the presence of peritonitis with and without protection by a vicryl mesh. One hundred and thirty rats were operated. 1) Thirty small bowel anastomoses were performed in a sterile environment to evaluate the morbidity and mortality due to the surgical procedure itself. All these animals had an uneventful course. 2) Forty anastomoses were done in a septic environment without protection. Twelve rats died immediately after the procedure. Six rats developed an anastomotic fistula and 22 had an uneventful course. 3) Sixty anastomoses were performed in a septic environment and protected by a vicryl mesh. Seventeen rats died immediately after the procedure. There were no anastomotic disruptions. Seventeen rats had an uneventful course, and 28 (46.7%) developed stenosis of the anastomosis. Protection of small bowel anastomoses by a vicryl mesh appears to effectively prevent disruptions and infections (no anastomotic fistulas or locoregional infections were recorded). However, the mesh is responsible for an intense inflammatory reaction, that often results in intestinal obstruction.
Siksik
J M
JM
Service de Chirurgie générale, Hôpital Laënnec, Paris, France.
D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000295:instrumentation; D000818:Animals; D003251:Constriction, Pathologic / Q000209:etiology; D007410:Intestinal Diseases / Q000209:etiology; D007421:Intestine, Small / Q000601:surgery*; D010538:Peritonitis / Q000150:complications*; D011098:Polyglactin 910 / Q000009:adverse effects / Q000627:therapeutic use*; D011108:Polymers / Q000627:therapeutic use*; D051381:Rats; D011919:Rats, Inbred Strains
D011108:Polymers; D011098:Polyglactin 910
Anastomoses de l'intestin grêle en milieu septique protégées par un treillis de vicryl.