Anastomotic blood-flow reduction in rat small intestine with chronic radiation damage.
OBJECTIVE
Anastomoses in previously irradiated intestine are prone to leakage, possibly due to an impeded blood supply. Whether or not chronic radiation damage actually predisposes to a disturbed blood flow in the vicinity of anastomoses was investigated in the rat small bowel.


METHODS
A 2-cm segment of rat ileum was irradiated with a single dose (21 Gy). After 20 weeks an anastomosis was created in the irradiated segment and in the corresponding segment of controls. Another 4 days later local blood flow was studied with the 14C-iodoantipyrine autoradiography technique in 16 sectors around the circumference both in the anastomotic segment and in a segment 4 mm apart.


RESULTS
In the anastomotic segment, the average blood flow was reduced in irradiated compared with non-irradiated animals in the mucosal layer (p = 0.034), but not in the muscular layer (p = 0.08). In the mesenteric quadrant blood flow was reduced in irradiated compared with non-irradiated animals, both in the mucosal layer (p = 0.012) and in the muscular layer (p = 0.05). More irradiated than non-irradiated animals showed a blood-flow reduction to 15% or more in 13-16 sectors both in the mucosal (p = 0.015) and the muscular layer (p = 0.04).


CONCLUSIONS
The results favor the hypothesis that anastomoses in previously irradiated intestine are vascularly compromized and thereby have an increased risk of leakage.
Jahnson
S
S
Department of Urology, Orebro Medical Center, Sweden.
Holtz
A
A
Gerdin
B
B
D000714:Anastomosis, Surgical; D000818:Animals; D000983:Antipyrine / Q000031:analogs & derivatives; D001345:Autoradiography; D001783:Blood Flow Velocity / Q000502:physiology / Q000528:radiation effects; D001835:Body Weight / Q000528:radiation effects; D002250:Carbon Radioisotopes; D002908:Chronic Disease; D007421:Intestine, Small / Q000098:blood supply* / Q000528:radiation effects* / Q000601:surgery; D008297:Male; D011833:Radiation Injuries, Experimental / Q000503:physiopathology*; D051381:Rats; D017207:Rats, Sprague-Dawley
D002250:Carbon Radioisotopes; D000983:Antipyrine; C008135:iodoantipyrine