The effect of tension on esophagogastric anastomotic wound healing in rats.
OBJECTIVE
The effect of tension on the occurrence of esophagogastric anastomotic leaks has been controversial for along time. We used a rat model and investigated the effect of tension on the esophagogastric anastomotic wound healing.


METHODS
Eighty Sprague-Dawley rats were divided into 8 groups and each group has 10 rats. A side-to-side single layer esophagogastric anastomosis was constructed using interrupted sutures through laparotomy. Anastomoses were excised on day 0, 3, 5, 7, 14, mounted in an Instronmini-44 Tension meter and distracted at 10 mm/min to measure breaking strength. On the other hand, the increased anastomotic tensions were obtained by increasing the distance between esophageal incision and gastrotomy, and anastomotic leak rates in different anastomotic tension groups were investigated.


RESULTS
A total of 11 rats were excluded from the studies because of pulmonary complication. Breaking strength on day 0, 3, 5, 7, 14 were 3.35+/-0.89, 1.18+/-0.31, 1.92+/-0.46,3.47+/-0.83, 5.06+/-1.22 (Newton), respectively. The breaking strength is significantly different between day 0 and day 3, day 5 and day 7, day 7 and day 14 (p<0.05). There is no difference between day 3 and day 5, day 0 and day 7(p>0.05). Breaking strength is lowest on day 3 and close to culmination on day 14. Esophagogastric anastomotic leaks increased along with anastomotic tension increasing.


CONCLUSIONS
Anastomotic tension could be a key factor resulting in esophagogastric anastomotic leaks.
Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, NY, USA. ycui3103@hotmail.com
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Cui
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Chen
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D019245:Compressive Strength; D004195:Disease Models, Animal; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D011336:Probability; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013529:Surgical Wound Dehiscence; D013536:Suture Techniques; D014945:Wound Healing / Q000502:physiology