García-Olmo D, Lucas F J, Payá J, López-Fando J
Unidad de Investigación, Servicio de Cirurgía General, Hospital General Albacete, España.
Nutr Hosp. 1994 Nov-Dec;9(6):385-93.
We made an experimental study of the influence of the peritoneal adherence process on the strength of colic anastomosis.
60 rats, in three groups of 20. Group I, colic anastomosis; Group II, colic anastomosis with epipoplasty; Group III, colic anastomosis covered with plastic material. They were slaughtered on the fourth post-operative day and we assessed the adherence parameters, removing the segment with anastomosis and measuring its breakage strength. Laplace's Law was applied to calculate Wall Breakage Stress (WBS).
Group I: The statistically most significant influence on WBS was that of adherences to the anastomotic line (p = 0.005). WBS measured in anastomosis with adherence on 100% of the circumference was greater than in those where some part remained to be covered (p = 0.006). Group II: mean WBS was higher than in Group I as a whole (p = 0.005) and similar to that of the anastomosis in this group 100% covered by adherences (p = 0.017). Group III: mean WBS was lower than that of Group I (p = 0.009) and Group II (p = 0.000).
The beneficial effect was demonstrated of adherences to the anastomotic line on the strength of colic anastomosis so that this process should not, wherever possible, be obstructed. During an epiploplasty, 100% coverage must be ensured: this technique must therefore be considered to belong to the group of high-risk colic anastomoses.
我们对腹膜粘连过程对结肠吻合强度的影响进行了实验研究。
60只大鼠，分为三组，每组20只。第一组，结肠吻合术；第二组，结肠吻合术加网膜成形术；第三组，结肠吻合术覆盖塑料材料。术后第四天将它们处死，评估粘连参数，取出吻合段并测量其断裂强度。应用拉普拉斯定律计算壁断裂应力（WBS）。
第一组：对WBS统计学上最显著的影响是吻合口处的粘连（p = 0.005）。在吻合口周长100%有粘连的情况下测量的WBS大于部分仍未被覆盖的情况（p = 0.006）。第二组：总体平均WBS高于第一组（p = 0.005），且与该组100%被粘连覆盖的吻合口相似（p = 0.017）。第三组：平均WBS低于第一组（p = 0.009）和第二组（p = 0.000）。
已证明吻合口处的粘连对结肠吻合强度有有益作用，因此只要有可能，不应阻碍这一过程。在进行网膜成形术时，必须确保100%覆盖：因此该技术应被视为高风险结肠吻合术之一。
