Evaluation of anastomotic microcirculation after low anterior rectal resection: an experimental study with different reconstruction forms in dogs.
BACKGROUND
Data on anastomotic microcirculation of coloanal anastomoses are contradictory. Therefore, it was the aim of the present study to investigate perianastomotic blood perfusion in a standardized experimental setting comparing three forms of reconstruction using laser fluorescence videography, a new method for the evaluation of microcirculation.


METHODS
After a standardised rectal resection in dogs, reconstruction was performed as straight end-to-end (n = 6), side-to-end (n = 6), or J-pouch (n = 6) coloanal anastomosis. Bowel perfusion was evaluated using IC-View laser fluorescence videography.


RESULTS
The perfusion index was significantly reduced in all three groups compared to the reference regions: endto-end anastomosis, median, 93% (range, 63%-136%); side-to-end-anastomosis, 65% (35%-138%); colonic-J-pouch anal anastomosis, 52% (32%-72%); p < 0.001).


CONCLUSIONS
Straight coloanal anastomoses provide better anastomotic microcirculation after rectal resections than colonic-J-pouch anal anastomoses or side-to-end anastomoses. However this effect does not seem to be decisive for the prevention of anastomotic leaks.
Willis
S
S
Department of Surgery, RWTH Aachen, Aachen, Germany. swillis@ukaachen.de
Hölzl
F
F
Krones
C J
CJ
Tittel
A
A
Schumpelick
V
V
D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D003082:Colectomy; D004285:Dogs; D008833:Microcirculation; D011184:Postoperative Period; D019651:Plastic Surgery Procedures; D012007:Rectum / Q000098:blood supply* / Q000601:surgery*; D017792:Surgical Stapling; D014741:Video Recording / Q000379:methods