[Animal experiment study of anastomosis healing after partial resection of the pre-irradiated thoracic esophagus].
BACKGROUND
Multimodal therapeutic concepts in cases of neoplasms of the intestinal tract entail the risk of undesirable complications with respect to healing of wounds and anastomoses. The separate steps of a combined treatment consisting radiation therapy and partial resection of the thoracic esophagus were performed in animal experiments to study the effect of radiation therapy on the healing of anastomoses.


METHODS
Adult non-purebred dogs were irradiated in a defined thoracic field with a Betatron (42 MeV) and subsequently underwent esophagectomy. After resection of a 2 cm segment of the esophagus end-to-end anastomosis was performed. Different methods of irradiation and postoperative observation times resulted in a total of 8 groups of 3 animals each.


RESULTS
Fractionated irradiation was definitely better tolerated than irradiation with a high single doses. The temporary delay of the anastomotic healing was documented histologically. Only one case of anastomotic leakage occurred, and impaired wound healing was observed in only one animal.


CONCLUSIONS
The mode of irradiation must be regarded as important for the clinical course. Fractionated preoperative irradiation in the area of the thoracic esophagus does not lead to any relevant disturbance of wound and anastomotic healing with meticulous surgical technique and adequate intensive postoperative care. The basic feasibility of surgical therapy combined with preoperative radiotherapy in tumors of the upper digestive tract was confirmed by our experimental work.
Engel
C
C
Chirurgische Klinik des Krankenhauses Neunkirchen, Städt. Klinikum Kemperhof Koblenz.
Nilles-Schendera
A
A
Frommhold
H
H
D000714:Anastomosis, Surgical; D000818:Animals; D004285:Dogs; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D016629:Esophagectomy; D004947:Esophagus / Q000473:pathology / Q000528:radiation effects*; D020360:Neoadjuvant Therapy; D011833:Radiation Injuries, Experimental / Q000473:pathology*; D013529:Surgical Wound Dehiscence / Q000473:pathology; D014945:Wound Healing / Q000528:radiation effects*