Reinforcement of colon anastomoses with polyglycolic acid mesh: an experimental study.

Polyglycolic acid (PGA) meshes have successfully been used in the treatment of injured parenchymatous organs. In our study we investigated the value of PGA meshes for reinforcement of colon anastomoses in a rat model. In 75 Wistar rats the transverse colon was transected and reanastomosed in a single-layer technique. The anastomoses in half of the animals were performed with 6 stitches. In the other animals the anastomoses were performed with 4 stitches only and were therefore supposed to leak. In half of the animals of each group a PGA mesh was used to cover the anastomoses. Animals of each group were sacrificed after 2, 4, 8, 30 and 60 days. The bursting strength of the anastomoses was determined and the anastomosed region was examined histologically. The results demonstrate that regardless of how the anastomosis was applied motility disorders, delayed healing or leakage followed by peritonitis only occurred in animals in which a PGA mesh was used. The determination of the bursting strength also showed a marked decrease in all rats in which the anastomosis was reinforced with a PGA mesh. We therefore conclude that PGA mesh application in colon anastomoses results in impaired healing, which is probably due to reduced peritoneal or omental contact.

[Securing colon anastomoses by surrounding it with a polyglycolic acid filament net. An animal experiment study]. / Sicherung von Kolonanastomosen durch Umhüllung mit einem Polyglykolsäure-Filament-Netz. Eine tierexperimentelle Studie.

Resorbable polyglycolic-acid (PGA)-nets are used successfully for the treatment of traumatic ruptures of parenchymous organs. This experimental study was carried out to investigate whether PGA-nets can also re-enforce jeopardized colon anastomoses. In 75 Wistar rats the transverse colon was transsected and reanastomosed. Animals were divided into 2 groups: in one group the anastomosis was applied sufficiently, in the other group the anastomosis was applied potentially insufficient. Out of each group a PGA-net was placed around the anastomosis in one half of the animals. The results demonstrated that delayed healing of the anastomoses as well as spontaneous suture line disruptions followed by peritonitis only occurred in those animals in which a PGA-net had been used. The evaluation of the bursting strength could confirm this finding of delayed consolidation. The bursting pressure therefore was significantly decreased in all animals in which a PGA-net had been applied, compared to the control group operated without PGA-net application. We therefore conclude that PGA-net application in colon anastomoses inhibits the consolidation of the suture line, probably because of a lack of contact to the peritoneal and omental tissue.