Effects of an intra-abdominal latex (drain-like) tube on anastomotic resistance and adhesion formation in a rat model.

PURPOSE

Aim of the present study was to determine effect of a latex drain on colonic resistance and its relation to adhesion phenomena.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.