Effects of lymph stasis on healing of rat intestinal anastomosis.

The effects of lymphatic drainage on ileal anastomotic healing using interrupted polyglycolic acid sutures were studied in rats after division and obstruction of celiac-mesenteric lymphatics, and the data compared with sham-operated controls. In 4 of 20 rats with lymph stasis, but not sham-controls, anastomotic leakage was associated with generalized peritonitis and death. Histologic examination of the anastomotic site at 7 and 14 days revealed prolonged exudation with acute inflammatory reaction and less prominent granuloma formation where lymphatics were interrupted. Whereas foreign body giant cell reaction predominated at 14 days with lymph stasis, histiocytic and fibroblastic proliferation dominated in sham-controls. The data suggest that an intact lymphatic system favors optimal intestinal healing and repair.