The effects of the pharmacological manipulation of postoperative intestinal motility on colonic anastomoses. An experimental study in a rat model.
BACKGROUND
The aim of the study was to determine the effects of pharmacological manipulation of postoperative intestinal motility on the resistance of colonic anastomoses.


METHODS
Seventy-one Sprague-Dawley rats were divided into three groups: Group 1 (n = 20; colonic anastomosis+1 cc of saline solution subcutaneously, daily); Group 2 (n = 29; colonic anastomosis+1.2 mg/100 g body weight metoclopramide in 1 cc subcutaneously, daily); and Group 3 (n = 22; colonic anastomosis+2 mg/100 g body weight hyoscine N-butyl-bromide in 1 cc subcutaneously, daily). Surviving rats (20 in each group) were sacrificed 4 days after surgery and adhesions were evaluated. Each segment containing an anastomosis was removed and the bursting pressure was determined.


RESULTS
The cause of death during the early postoperative period was dehiscence in 8 cases (7 in Group 2 and 1 in Group 3). General adhesion scores in Group 2 were higher than in Group 3 (P = 0.003). The score for adhesions to the anastomosis in Group 1 was higher than in Group 2, but no statistically significant difference was found. Bursting-pressure was significantly lower in Group 2 than in other groups (P = 0.001). In all cases leakage of dye was observed at the anastomosis.


CONCLUSIONS
The use of metoclopramide (a gastrointestinal prokinetic agent) during the early postoperative period was associated with an increase in dehiscence in colonic anastomosis and, when animals survived, there was a significant decrease in anastomotic resistance. Hyoscine (an inhibitor of gastrointestinal motility) did not improve the healing of anastomoses.
García-Olmo
D
D
Experimental Surgery Unit, Albacete General Hospital, Spain.
Payá
J
J
Lucas
F J
FJ
García-Olmo
D C
DC
D000714:Anastomosis, Surgical; D000818:Animals; D002086:Butylscopolammonium Bromide / Q000494:pharmacology*; D003106:Colon / Q000187:drug effects* / Q000502:physiology / Q000601:surgery; D005260:Female; D005765:Gastrointestinal Agents / Q000494:pharmacology*; D005769:Gastrointestinal Motility / Q000187:drug effects*; D008297:Male; D008787:Metoclopramide / Q000494:pharmacology*; D015999:Multivariate Analysis; D011184:Postoperative Period; D011446:Prospective Studies; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D014945:Wound Healing / Q000187:drug effects
D005765:Gastrointestinal Agents; D002086:Butylscopolammonium Bromide; D008787:Metoclopramide