title: Effect of intraoperative PEEP application on colonic anastomoses healing: An experimental animal study.
abstract: OBJECTIVE
  This study aimed to assess the effect of intraoperative PEEP intervention on the healing of colonic anastomoses in rabbits.
  
  
  METHODS
  Thirty-two New Zealand type male rabbits were divided into two groups of sixteen animals each. Following ventilation with tracheostomy, colonic resection and anastomosis were performed in both groups. While 10 cm H2O PEEP level was applied in Group I (PEEP), Group II (ZEEP) was ventilated without PEEP throughout the surgery. Half of the both PEEP and ZEEP group animals were killed on the third postoperative day, while the remaining half on the seventh. Anastomotic bursting pressures, the tissue concentrations in hydroxyproline, and histological assessments were performed. Besides, intraoperative oxygen saturation and postoperative arterial blood gas parameters were also compared.
  
  
  RESULTS
  On the first postoperative day, both arterial oxygen tension (PO2) and oxygen saturation (SO2) in the PEEP group were significantly higher than in the ZEEP group. On the seventh postoperative day, the bursting pressures of the anastomoses were significantly higher in the PEEP group, however the hydroxyproline content was significantly lower in the PEEP group than that in the ZEEP group. At day 7, PEEP group was significantly associated with increased neoangiogenesis compared with the ZEEP group.
  
  
  CONCLUSIONS
  The anastomotic healing process is positively influenced by the intraoperative PEEP application.
authors.affiliation: Akdeniz University, Faculty of Medicine, Antalya, 07058, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Turkoglu
authors.forename: Erdal Birol
authors.initials: EB
authors.lastname: Bostancı
authors.forename: Hasan
authors.initials: H
authors.lastname: Bilgili
authors.forename: Yıldız
authors.initials: Y
authors.lastname: Türkoğlu
authors.forename: Ümit
authors.initials: Ü
authors.lastname: Karadeniz
authors.forename: Gülden
authors.initials: G
authors.lastname: Aydoğ
authors.forename: Uğur
authors.initials: U
authors.lastname: Erçin
authors.forename: Ayşe
authors.initials: A
authors.lastname: Bilgihan
authors.forename: İlter
authors.initials: İ
authors.lastname: Özer
authors.forename: Musa
authors.initials: M
authors.lastname: Akoğlu
keywords: anastomotic bursting pressure; colon anastomosis; neoangiogenesis; positive end-expiratory pressure