Ulus Travma Acil Cerrahi Derg. 2014 Nov;20(6):401-9. doi: 10.5505/tjtes.2014.31899.

The fate of suboptimal anastomosis after colon resection: An experimental study.

Yıldız MK1, Okan İ2, Nazik H3, Bas G4, Alimoglu O5, İlktac M3, Daldal E6, Sahin M2, Kuvat N3, Ongen B3.

Author information

• 1Department of General Surgery, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey. mehmetkamilyildiz@yahoo.com.
• 2Department of General Surgery, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
• 3Department of Microbiology and Clinical Microbiology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.
• 4Department of Surgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.
• 5Department of Surgery, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey.
• 6Department of General Surgery, Vakıf Gureba Training and Research Hospital, İstanbul, Turkey.

Abstract

BACKGROUND:

The fate of suboptimal anastomosis is unknown and early detection of anastomotic leakage after colon resection is crucial for the proper management of patients.

METHODS:

Twenty-six rats were assigned to "Control", "Leakage" and "Suboptimal anastomosis" groups where they underwent either sham laparotomy, cecal ligation, and puncture or anastomosis with four sutures following colon resection, respectively. At the fifth hour and on the third and ninth days; peripheral blood and peritoneal washing samples through relaparotomy were obtained. The abdomen was inspected macroscopically for anastomotic healing. Polymerase chain reaction (PCR) with 16s rRNA and E.coli-specific primers were run on all samples along with aerobic and anaerobic cultures.

RESULTS:

The sensitivity and specificity of PCR on different bodily fluids with 16s rRNA and E.coli-specific primers were 100% and 78%, respectively. All samples of peritoneal washing fluids on the third and ninth days showed presence of bacteria in both PCR and culture. The inspection of the abdomen revealed signs of anastomotic leakage in eight rats (80%), whereas mortality related with anastomosis was detected in two (20%).

CONCLUSION:

Anastomotic leakage with suboptimal anastomosis after colon resection is high and the early detection is possible by running PCR on peritoneal samples as early as 72 hours.