title: Colorectal anastomotic leakage: a new experimental model.
abstract: BACKGROUND
  Anastomotic leakage is the major complication after colorectal surgery. To date, animal experiments concerning colorectal anastomosis focus on anastomotic healing instead of anastomotic leakage. This study aims to develop a new experimental model for colorectal anastomotic leakage.
  
  
  METHODS
  A control group, receiving an anastomosis with 12 interrupted sutures, was compared to a group receiving an anastomosis with 6 interrupted sutures. When the leakage rate was observed to be too low, the number of sutures was decreased stepwise, to 5 or less. Each group contained 9 "C57Bl6-mice". After 7 d the Anastomotic Bursting Pressure (ABP) was determined.
  
  
  RESULTS
  In the first experiment, one mouse (11.1%) in the case group and none in the control group developed leakage. Average ABP was 152.2 mmHg in the control group and 138,8 mmHg in the case group (P=0.111). In the second experiment, case group receiving an anastomosis with 5 sutures, 4 mice (44.4%) in the case group developed leakage. This experiment was repeated twice resulting in leakage rates of 33.3% and 44.4%. The average overall ABP in the case group was 142.7 mmHg vs. 179.9 mmHg (P=0.022) in the control group. The mice without leakage showed a stabilization of average weight loss around day 2 and 3 and a decrease afterwards. The mice with leakage showed a decrease only after day 5. The difference in wellness-scores between the groups with- and without leakage was 2 points, increasing during follow-up.
  
  
  CONCLUSIONS
  The model of anastomotic leakage caused by creating an anastomosis with 5 interrupted sutures is feasible. Weight loss and wellness-scores are good predictors of leakage.
authors.affiliation: Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. nielskomen@hotmail.com
authors.forename: Niels
authors.initials: N
authors.lastname: Komen
authors.forename: Hans-Christiaan
authors.initials: HC
authors.lastname: van der Wal
authors.forename: Max
authors.initials: M
authors.lastname: Ditzel
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: Kleinrensink
authors.forename: Hans
authors.initials: H
authors.lastname: Jeekel
authors.forename: Johan F
authors.initials: JF
authors.lastname: Lange
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects*; D000818:Animals; D004195:Disease Models, Animal; D007416:Intestinal Perforation / Q000209:etiology*; D051379:Mice; D008810:Mice, Inbred C57BL; D013536:Suture Techniques