Intraoperative bowel irrigation improves anastomotic collagen metabolism in the left-sided colonic obstruction but not covering colostomy

• Published in: International journal of colorectal disease 1998-12, Vol.13 (5-6), p.232-234
• Main Authors: DURAKER, N, BENDER, Ö, MEMISOGLU, K, YALCINER, A
• Format: Article
• Language: English
• Subjects: Anastomosis, Surgical - methods; Animals; Biological and medical sciences; Collagen; Collagen - metabolism; Colon; Colon - metabolism; Colon - surgery; Colonic Diseases - metabolism; Colonic Diseases - surgery; Colostomy; Hydroxyproline - analysis; Intestinal Obstruction - metabolism; Intestinal Obstruction - surgery; Intraoperative Care; Irrigation; Male; Medical sciences; Metabolism; Ostomy; Random Allocation; Rats; Rats, Sprague-Dawley; Rodents; Statistics, Nonparametric; Stomach, duodenum, intestine, rectum, anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Therapeutic Irrigation; Wound Healing - physiology
• ISSN: 0179-1958; 1432-1262
• DOI: 10.1007/s003840050167

This study investigated the effects of intraoperative colonic irrigation and proximal diverting end colostomy after segmental bowel resection in experimental left-colonic obstruction on anastomotic healing. Simple obstruction of descending colon was performed in male Sprague-Dawley rats. After 24 h we performed segmental colonic resection and anastomosis in the control group (n = 15); resection, anastomosis, and covering colostomy in the colostomy group (n = 14); resection and anastomosis after antegrade colonic lavage through cecum by using isotonic saline solution in the irrigation group (n = 13). In rats that were killed 7 days later anastomotic dehiscence and bursting pressure and tissue hydroxyproline concentration at the anastomosis were measured. No significant differences were observed between groups in terms of anastomotic dehiscence, bursting site, or pressure. The hydroxyproline concentration was significantly higher in the irrigation group than the control group (P = 0.025) and the colostomy group (P = 0.029), but no difference was noted between the control group and the colostomy group. These findings suggest that intraoperative antegrade colonic irrigation in the acute left-sided colonic obstruction positively affects collagen metabolism at the anastomotic site; if the anastomosis is performed without bowel cleansing, covering colostomy does not improve collagen metabolism.