1st Propedeutic Surgical Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, T.Ikonimidi 21, 551 31 Kalamaria, Thessaloniki, Greece.
Tech Coloproctol. 2010 Nov;14 Suppl 1:S53-5. doi: 10.1007/s10151-010-0611-2.
The present study is aiming at elucidating the effect of intraoperative lavage with short-chain fatty acids (SCFAs) on colonic anastomosis in rats.
Forty male Wistar rats were randomized into four groups (10 rats each). After resection of a segment of transverse colon, an end-to-end anastomosis was performed. In the 1st group, no intraoperative large bowel lavage was performed; in the 2nd, a lavage with normal saline solution; in the 3rd, the animals received a diet rich in SCFAs pre- and postoperatively, and a lavage with normal saline was performed; and in the 4th group, an intraoperative lavage with SCFAs was carried out. On the 4th postoperative day, the animals were sacrificed. Septic complications, adhesions and anastomoses were graded macroscopically and histologically, and bursting pressure of the anastomoses, CRP, IL-6 and TNF-a was measured.
Fewer septic complications (abscesses and minimal ruptures) and adhesions were observed in the 4th group with the intraoperative lavage with SCFAs. The bursting pressure also, in the same group, was higher (73.3 mmHg), followed by the 1st group (67.1 mmHg).
Intraoperative lavage with SCFAs increases the bursting pressure of colonic anastomoses, while lavage with saline solution decreases it, in comparison to the group without lavage.
本研究旨在阐明术中短链脂肪酸(SCFAs)灌洗对大鼠结肠吻合术的影响。
40 只雄性 Wistar 大鼠随机分为四组(每组 10 只)。切除一段横结肠后,进行端端吻合。第 1 组不行术中大肠灌洗;第 2 组用生理盐水灌洗;第 3 组术前和术后给予富含 SCFAs 的饮食,并进行生理盐水灌洗;第 4 组行术中 SCFAs 灌洗。术后第 4 天,处死动物。宏观和组织学分级评估脓毒症并发症、粘连和吻合口,并测量吻合口的爆裂压、CRP、IL-6 和 TNF-a。
第 4 组术中 SCFAs 灌洗后,脓毒症并发症(脓肿和最小破裂)和粘连较少。同一组的爆裂压也较高(73.3mmHg),其次是第 1 组(67.1mmHg)。
与未灌洗组相比,术中 SCFAs 灌洗可增加结肠吻合口的爆裂压,而生理盐水灌洗则降低其爆裂压。