The effects of scalpel, harmonic scalpel and monopolar electrocautery on the healing of colonic anastomosis after colonic resection.
OBJECTIVE
In our study, the effects of harmonic scalpel, scalpel, and monopolar electrocautery usage on the health and healing of colon anastomosis after resection was investigated.


METHODS
In this study, 120 female albino Wistar rats were divided into 3 groups each containing 40 rats. Group A, resection with scalpel; group B, resection with monopolar electrocautery; group C, resection with harmonic scalpel. The groups were divided into 4 subgroups consisting of 10 rats and analysed in the postoperative 1st, 3rd, 5th, and 7th days. Anastomotic bursting pressures, hydroxyproline levels and histopathological parameters were surrogate parameters for evaluating wound healing.


RESULTS
The tissue hydroxyproline levels did not show any significant difference between the groups and subgroups. The mean bursting pressure of group A on the 5th day was significantly higher than groups B and C (P < 0.001). When the fibroblast and fibrosis scores were evaluated, scores of group C on the 5th day were significantly higher than the other groups, but the results of bursting pressures and biochemical parameters did not support the fibroblast and fibrosis scores. There were not any significant differences between the groups in other histopathologic parameters.


CONCLUSIONS
The use of monopolar electrocautery needs more attention since the device causes tissue destruction. The obliterating effect of harmonic scalpel on luminal organs is an important problem, especially if an anastomosis is planned. Despite the disadvantages of scalpel, its efficacy on early wound healing is better than the other devices.
Department of General Surgery, Ankara Education and Research Hospital, Ankara, Turkey.
Gökhan
G
Karaca
Department of General Surgery, Ankara Education and Research Hospital, Ankara, Turkey.
M Recep
MR
Pekcici
Department of Pathology, Ankara Education and Research Hospital, Ankara, Turkey.
Canan
C
Altunkaya
Department of Biochemistry, Ankara Education and Research Hospital, Ankara, Turkey.
Vildan
V
Fidanci
Department of Biochemistry, Ankara Education and Research Hospital, Ankara, Turkey.
Aytul
A
Kilinc
Department of General Surgery, Ankara Education and Research Hospital, Ankara, Turkey.
Huseyin
H
Ozer
Yil University, Faculty of Veterinary, Van, Turkey.
Ahmet
A
Tekeli
Department of General Surgery, Kirikkale University Medical Faculty, Kirikkale, Turkey.
Kuzey
K
Aydinuraz
Department of General Surgery, Ankara Education and Research Hospital, Ankara, Turkey.
Osman
O
Guler
Anastomosis healing; Colon; Electrosurgery; Surgical anastomosis