Perianastomotic colonic tumors after inclusion of titanium or Lactomer in the anastomotic suture line. An experimental study in rats.
OBJECTIVE
The aim of the study was to find out if there are differences in the incidence of colonic tumors at the anastomosis after the inclusion of titanium or the absorbable material Lactomer in the anastomotic suture line.


METHODS
Experimental study with 30 male Sprague-Dawley rats, assigned to 1 of 3 study groups: control (colonic anastomosis with interrupted suture); inclusion of titanium (8 mg) in the anastomotic suture line; and inclusion of Lactomer (8 mg) in the anastomotic line. After pharmacological carcinogenesis with 1-2 dimethylhydrazine, perianastomotic tumors were studied in the 20th postoperative week.


RESULTS
The inclusion of titanium in the anastomotic line led to more tumors, a larger anastomotic tumoral area and a larger percentage of tumoral area than Lactomer (p < 0.05). The inclusion of Lactomer may have a protective effect against the induction of cancer in the anastomotic area.


CONCLUSIONS
Titanium, a material used in mechanical instruments for digestive tract anastomoses, is not an innocuous material. Its presence in the anastomotic line can promote colonic carcinogenesis after induction. The use of mechanical staplers for colonic anastomoses should be relegated to difficult anastomoses that cannot be sewn manually.
Noguera Aguilar
J F
JF
General Surgery and Digestive Diseases Service, Son Dureta University Hospital, Baleares, Spain.
Zurita Romero
M
M
Tortajada Collado
C
C
Amengual Antich
I
I
Soro Gosálvez
J A
JA
Rial Planas
R
R
D019813:1,2-Dimethylhydrazine; D000704:Analysis of Variance; D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D002273:Carcinogens; D003106:Colon / Q000601:surgery*; D003110:Colonic Neoplasms / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology; D008297:Male; D011108:Polymers; D051381:Rats; D017207:Rats, Sprague-Dawley; D013537:Sutures; D014025:Titanium
D002273:Carcinogens; D011108:Polymers; C048851:polysorb; D014025:Titanium; D019813:1,2-Dimethylhydrazine