[The relation of the adhesion phenomenon and the experimental resistance of colonic anastomoses. The effect of epiploplasty].
BACKGROUND
We made an experimental study of the influence of the peritoneal adherence process on the strength of colic anastomosis.


METHODS
60 rats, in three groups of 20. Group I, colic anastomosis; Group II, colic anastomosis with epipoplasty; Group III, colic anastomosis covered with plastic material. They were slaughtered on the fourth post-operative day and we assessed the adherence parameters, removing the segment with anastomosis and measuring its breakage strength. Laplace's Law was applied to calculate Wall Breakage Stress (WBS).


RESULTS
Group I: The statistically most significant influence on WBS was that of adherences to the anastomotic line (p = 0.005). WBS measured in anastomosis with adherence on 100% of the circumference was greater than in those where some part remained to be covered (p = 0.006). Group II: mean WBS was higher than in Group I as a whole (p = 0.005) and similar to that of the anastomosis in this group 100% covered by adherences (p = 0.017). Group III: mean WBS was lower than that of Group I (p = 0.009) and Group II (p = 0.000).


CONCLUSIONS
The beneficial effect was demonstrated of adherences to the anastomotic line on the strength of colic anastomosis so that this process should not, wherever possible, be obstructed. During an epiploplasty, 100% coverage must be ensured: this technique must therefore be considered to belong to the group of high-risk colic anastomoses.
Unidad de Investigación, Servicio de Cirurgía General, Hospital General Albacete, España.
D
D
García-Olmo
F J
FJ
Lucas
J
J
Payá
J
J
López-Fando
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D003106:Colon / Q000473:pathology / Q000601:surgery*; D003108:Colonic Diseases / Q000473:pathology / Q000601:surgery*; D005260:Female; D008297:Male; D009852:Omentum / Q000637:transplantation*; D010537:Peritoneum / Q000473:pathology; D051381:Rats; D017207:Rats, Sprague-Dawley; D012422:Rupture, Spontaneous; D013529:Surgical Wound Dehiscence / Q000473:pathology / Q000517:prevention & control; D013536:Suture Techniques; D000267:Tissue Adhesions / Q000473:pathology
Relación entre el fenómeno adherencial y la resistencia experimental de las anastomosis cólicas. Influencia de la epiploplastia.