Evaluation of anastomotic microcirculation after low anterior rectal resection: an experimental study with different reconstruction forms in dogs

• Published in: Techniques in coloproctology Vol. 10; no. 3; pp. 222 - 226
• Main Authors: Willis, S, Hölzl, F, Krones, C J, Tittel, A, Schumpelick, V
• Format: Journal Article
• Language: English
• Published: Italy Springer Nature B.V 01-10-2006
• Subjects: Anastomosis, Surgical - methods; Animals; Colectomy; Dogs; Microcirculation; Postoperative Period; Reconstructive Surgical Procedures; Rectum - blood supply; Rectum - surgery; Surgical Stapling; Video Recording - methods
• ISSN: 1123-6337; 1128-045X
• DOI: 10.1007/s10151-006-0283-0

Data on anastomotic microcirculation of coloanal anastomoses are contradictory. Therefore, it was the aim of the present study to investigate perianastomotic blood perfusion in a standardized experimental setting comparing three forms of reconstruction using laser fluorescence videography, a new method for the evaluation of microcirculation.
After a standardised rectal resection in dogs, reconstruction was performed as straight end-to-end (n = 6), side-to-end (n = 6), or J-pouch (n = 6) coloanal anastomosis. Bowel perfusion was evaluated using IC-View laser fluorescence videography.
The perfusion index was significantly reduced in all three groups compared to the reference regions: endto-end anastomosis, median, 93% (range, 63%-136%); side-to-end-anastomosis, 65% (35%-138%); colonic-J-pouch anal anastomosis, 52% (32%-72%); p < 0.001).
Straight coloanal anastomoses provide better anastomotic microcirculation after rectal resections than colonic-J-pouch anal anastomoses or side-to-end anastomoses. However this effect does not seem to be decisive for the prevention of anastomotic leaks.