Effects of portal triad occlusion on left-sided colonic anastomosis.
Anastomotic healing can deteriorate because of different local and systemic effects in cases of concomitant left colon and liver injuries. We evaluated the effects of portal triad occlusion (PTO) on bowel anastomosis after concomitant segmental left colonic resections achieved in rats. There were three separate groups of animals; each consisted of 20 Sprague-Dawley male rats weighing 250 +/- 20 g. In group I, left colonic segmental resection 1 cm in diameter and anastomosis were performed as controls. In group II, the same surgical procedure was done after 15 minutes of PTO followed by 30 minutes of reperfusion. In group III, PTO time was held at 30 minutes. The rats were killed at days 4 and 7 to evaluate anastomotic healing, histological changes, bursting pressures, and serum levels of malondialdehyde (MDA) and hydroxyproline. In group II, the bursting pressures of anastomosis on days 4 and 7 were similar to group I; these pressures were significantly lower in group III (P < 0.001), whereas the hydroxyproline levels in group II were lower than group I and group III levels (P < 0.002). There were histopathological changes that support the data found in groups II and III. Serum MDA levels in groups II and III were significantly higher than in group I (P < 0.001). We observed that serum MDA levels peaked at day 4 and gradually decreased with a statistically significant difference at day 7. In conclusion, there were no negative effects of PTO on colonic anastomosis in group II. But in group III, with longer occlusion times, anastomotic healing was impaired and the mortality rate was higher.
Simsek
Abdurrahman
A
Department of General Surgery, Gulhane Military Medical Academy, Ankara, Turkey. abdurrahmansimsek@hotmail.com
Yagci
Gokhan
G
Zeybek
Nazif
N
Gorgulu
Semih
S
Kaymakcioglu
Nihat
N
Kesim
Emre
E
Akdeniz
Ali
A
Ozmen
M Mahir
MM
Renda
Nurten
N
D000714:Anastomosis, Surgical; D000818:Animals; D003106:Colon / Q000098:blood supply / Q000601:surgery*; D006801:Humans; D006909:Hydroxyproline / Q000032:analysis*; D008099:Liver / Q000098:blood supply*; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D018384:Oxidative Stress; D011168:Portal System / Q000503:physiopathology*; D011184:Postoperative Period; D051381:Rats; D017207:Rats, Sprague-Dawley
D008315:Malondialdehyde; D006909:Hydroxyproline