Latex rubber (Penrose drain) is detrimental to esophagogastric anastomotic healing in rats.
BACKGROUND
Surgeons commonly drain cervical esophagogastric anastomoses, but there is little objective evidence to support this practice. Studies in other areas of gastrointestinal surgery have shown that routine drainage is unnecessary, and even detrimental to anastomotic healing. We conducted an animal experiment to see if a drain had a negative effect on esophagogastric anastomotic healing.


METHODS
Esophagogastric anastomoses were done in 40 rats. In the experimental group (20 rats) a portion of latex rubber Penrose drain was placed over the anastomosis. This was not done in the control group (20 rats). Rats were sacrificed 7 days after surgery. The anastomoses were inspected for leaks, distracted in a tensiometer to measure breaking strength, and subjected to hydroxyproline analysis (an indicator of wound collagen).


RESULTS
There were 4 contained leaks in the experimental group (drain) and no leaks in the control rats (p=0.033). Anastomotic breaking strength was 3.80+/-0.81 N in the experimental rats and 3.46+/-0.64 N in the control rats (p=0.18, not significant). Anastomotic tissue hydroxyproline concentration was 615.9+/-52 nmol/mg in the experimental rats and 609.4+/-195 nmol/mg in the control rats (p=0.13, not significant).


CONCLUSIONS
The presence of drain material predisposed to esophagogastric anastomotic leakage in this rat model.
Cui
Y
Y
Department of Thoracic Surgery, Roswell Park Cancer Institute, State University of New York at Buffalo, USA.
Urschel
J D
JD
D000714:Anastomosis, Surgical; D000818:Animals; D001672:Biocompatible Materials / Q000737:chemistry; D015415:Biomarkers; D003094:Collagen / Q000378:metabolism; D004947:Esophagus / Q000166:cytology / Q000378:metabolism / Q000601:surgery*; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism; D006909:Hydroxyproline / Q000032:analysis; D019736:Prostheses and Implants; D051381:Rats; D017207:Rats, Sprague-Dawley; D012408:Rubber / Q000737:chemistry; D013270:Stomach / Q000166:cytology / Q000601:surgery*; D013718:Tensile Strength; D014945:Wound Healing / Q000502:physiology*
D001672:Biocompatible Materials; D015415:Biomarkers; D012408:Rubber; D003094:Collagen; D006909:Hydroxyproline