García-Olmo D, Lucas F J, Payá J
Experimental Surgery Unit, Albacete General Hospital, Albacete, Spain.
Dis Colon Rectum. 1996 Mar;39(3):311-7. doi: 10.1007/BF02049474.
Aim of the present study was to determine effect of a latex drain on colonic resistance and its relation to adhesion phenomena.
Forty Sprague-Dawley rats were divided into two groups (n = 20): Group 1, simple colonic anastomosis; and Group 2, colonic anastomosis with drain "ad latum." Rats were sacrificed four days after surgery, and adhesions were evaluated. Segment containing anastomosis was removed, and bursting pressure was determined.
General adhesion scores in Group 2 were higher than in Group 1 (P = 0.002). Score for adhesions to anastomotic line in Group 1 was higher than in Group 2 (P = 0.016). Bursting pressure was significantly lower in Group 2 (Group 1, 67.90 +/- 31.39 mmHg; Group 2, 46.95 +/-1 29.69 mmHg; P = 0.034). In all cases, leakage of dye was observed at the anastomotic line. A multiple regression test was applied to both groups (40 cases), taking bursting pressure as the dependent variable and other parameters as independent variables. A strong relationship appeared to exist between anastomotic resistance and fraction of anastomotic line that was covered by the neighboring organ (P < 0.001).
Placing a latex drain near a colonic anastomosis is associated with local inhibition of spontaneous adhesions to anastomotic line and, therefore, to significantly decreased resistance.
本研究旨在确定乳胶引流管对结肠阻力的影响及其与粘连现象的关系。
40只Sprague-Dawley大鼠分为两组（n = 20）：第1组，单纯结肠吻合术；第2组，带“ad latum”引流管的结肠吻合术。术后4天处死大鼠，评估粘连情况。切除含有吻合口的肠段，测定破裂压力。
第2组的总体粘连评分高于第1组（P = 0.002）。第1组吻合口处的粘连评分高于第2组（P = 0.016）。第2组的破裂压力显著较低（第1组，67.90 +/- 31.39 mmHg；第2组，46.95 +/- 29.69 mmHg；P = 0.034）。在所有病例中，吻合口处均观察到染料渗漏。对两组（40例）进行多元回归分析，以破裂压力为因变量，其他参数为自变量。吻合口阻力与被邻近器官覆盖的吻合口部分比例之间似乎存在密切关系（P < 0.001）。
在结肠吻合口附近放置乳胶引流管与局部抑制对吻合口的自发性粘连有关，因此与阻力显著降低有关。
