[Bursting pressure in normal and ischemic colonic anastomoses in rats; using biological and synthetic adhesives].
OBJECTIVE
We wanted to determine bursting pressure in normal and ischemic colonic anastomoses in rats as well as the frequency and type of complications with the use of biological and synthetic adhesives.


METHODS
We designed an experimental study using 80 Sprague-Dawley rats, weighing between 200 and 250 g, divided into four groups: one control group and three study groups. Anastomoses were realized using one layer of interrupted 6-0 polypropylene sutures. Each group was divided into two categories: normal colon (n = 10) and ischemic colon, induced by dividing mesenteric blood vessels (n = 10). Group 2 used octyl-cyanoacrylate, group 3 used N-2-butyl-cyanoacrylate, and group 4 used 40 mg/ml fibrinogen with 1000 u/ml of thrombin. Bursting pressure was measured with a manometer creating pressure in the anastomotic bowel using an infusion pump at 1 ml/min of NaCl 0.9%. Statistical analysis was performed with Student's t test, one-way ANOVA, chi square test or Fisher's exact test.


RESULTS
Group 1: (control) normal 127.8 +/- 16.21 versus 109 +/- 17 with ischemia (p < 0.05); group 2: normal 145.5 +/- 89 versus ischemic colon 97.6 +/- 40 (p = 0.136); group 3: normal 145.7 +/- 34 versus 130.8 +/- 15.33 with ischemia (p = 0.22); group 4: normal 239 +/- 26.4 versus 196.5 +/- 14.3 with ischemia (0.000). Bursting pressure was statistically significant in group 4, showing greater pressures (p < 0.001). Bursting segment was shown to be higher outside the anastomoses. Complications such as adhesions and intestinal obstruction were seen more frequently in both cyanoacrylate groups.


CONCLUSIONS
An increased bursting pressure was shown in the fibrinogen groups, having a greater tensile strength of the anastomoses. Pressures similar when anastomoses were treated with any of the other two synthetic adhesives.
Farías-Llamas
Oscar Alejandro
OA
Unidad de Investigación Médica en Epidemiología Clínica, Hospital de Especialidades, CMNO, IMSS, Guadalajara, Jalisco.
Orozco-Mosqueda
Abel
A
Portilla-del Buen
Eliseo
E
Leal-Cortés
Caridad A
CA
Ruiz-Chávez
Isaac Emmanuel
IE
González-Ojeda
Alejandro
A
D000714:Anastomosis, Surgical; D000818:Animals; D001672:Biocompatible Materials; D003106:Colon / Q000098:blood supply* / Q000601:surgery*; D005260:Female; D007511:Ischemia / Q000601:surgery*; D008422:Materials Testing / Q000379:methods*; D051381:Rats; D017207:Rats, Sprague-Dawley; D013314:Stress, Mechanical; D014014:Tissue Adhesives
D001672:Biocompatible Materials; D014014:Tissue Adhesives