Use of intraluminal protection in colonic anastomosis in dogs

Abstract

Purpose:To test the use of intraluminal protection in colonic anastomosis without intestinal cleansing. The intraluminal liner was fashioned from porcine submucosa preserved in glycerin and then fixed 10 cm anteriorly to the anastomotic site. This technique was compared with the one used in termino-terminal colonic anastomosis without intraluminal protection. Methods: Twenty-eight dogs were divided into two groups of fourteen animals each. Clinical and histopathological tests were performed on the fourth and twenty-first postoperative days. Results: The morbidity and mortality rates were higher in animals that did not receive the intraluminal liner. Histopathological examinations in animals in which the intraluminal liner was used showed better healing, characterized by milder inflammation and increased amount of collagen. Conclusion: It can be concluded that the use of intraluminal protection decreases complication rates in colonic anastomosis and promotes better healing. Key words: Anastomosis, Surgical. Colon. Suture Techniques. Wound Healing. Dogs. RESUMO Objetivo:Testar o uso da proteção intraluminal na anastomose colônica sem preparo intestinal. O protetor intraluminal usado foi confeccionado a partir da submucosa de suíno conservada em glicerina, e fixado a 10 cm cranialmente ao sítio anastomótico. Essa técnica foi comparada com a técnica de anastomose colônica término-terminal sem uso do protetor intraluminal. Métodos: Foram utilizados 28 cães divididos em dois grupos de 14 animais cada. A avaliação foi através de exames clínicos e histopatológicos. A avaliação anatomo-patológica foi realizada no quarto e vigésimo primeiro dias de pós-operatório. Resultados: Um maior número de casos de morbi-mortalidade foi observado nos animais operados sem o protetor intraluminal. O exame histopatológico dos animais nos quais foram usados os protetores intraluminais mostrou melhor cicatrização, caracterizada por processo inflamatório mais discreto e maior quantidade de colágeno. Conclusão: O uso do protetor diminui o número de complicações em anastomoses de cólon e melhora a cicatrização.

Feasibility of an Intraluminal Bypass Device in Low Colorectal Anastomosis

“…[12][13][14][15] However, none of these devices has been widely accepted, perhaps owing to the low level of evidence (mostly animal models and underpowered human studies). More recently, Oliveira et al 16 used an intraluminal device fashioned from a biological membrane to protect colonic anastomoses in dogs, with few complications and better healing than in controls. In 2011, researchers introduced the C-seal, a biodegradable intracolonic device that is glued to the anvil of a circular stapler for application to the bowel lumen.…”