Polypropylene mesh covered colonic anastomosis. Results of a new anastomosis technique.
BACKGROUND
The morbidity and mortality rates of anastomosis leakage of the gastrointestinal system, are high. In this study we covered the colonic anastomosis with polypropylene mesh on the safety of the anastomosis was investigated.


METHODS
Twenty female albino rabbits were divided into two groups. First of all, a segmental colon resection was performed in both the groups and a single layer of anastomosis was made. In addition, a polypropylene mesh as long as the circumference of the anastomosis in the study group. All the rabbits were sacrificed on the 10th postoperative day and the explosion pressure of the anastomosis, histopathological investigation of the anastomotic contour, and peritoneal adhesion were compared.


RESULTS
The anastomoses of all the subjects in the control group had exploded and the average explosion pressure was 149 +/- 16 mmHg. However, in the study group, the anastomoses did not explode in nine (90%) of the subjects, whereas it exploded in only one (10%) with a pressure of 260 mmHg. The average explosion pressure in the study group was 315 +/- 30 mmHg (p < 0.0001). No significant difference was established between the groups according to the histopathological classification of the anastomotic contour performed according to the Ehrlich-Hunt model (p > 0.05). Peritoneal adhesions of the groups is not statistically different (p > 0.05).


CONCLUSIONS
During the short follow-up period, this new technique significantly increased the safety of the anastomosis, moreover it did not cause any increase in peritoneal adhesions. This success has most probably occurred as a result of the external mechanical support to the anastomosis.
Istanbul Teaching Hospital, Department of General Surgery, K.M. Pasa, 34321 Istanbul, Marmara, Turkey. dr@webcerrah.com
Erhan
E
Aysan
Oguzhan
O
Dincel
Hasan
H
Bektas
Murat
M
Alkan
D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D003106:Colon / Q000473:pathology / Q000601:surgery*; D005260:Female; D010532:Peritoneal Diseases / Q000145:classification / Q000473:pathology; D011126:Polypropylenes; D011817:Rabbits; D012421:Rupture; D013526:Surgical Mesh; D000267:Tissue Adhesions / Q000145:classification / Q000473:pathology
D011126:Polypropylenes