A light-activated amnion wrap strengthens colonic anastomosis and reduces peri-anastomotic adhesions.
Lasers Surg Med
; 48(5): 530-7, 2016 07.
Article
em En
| MEDLINE
| ID: mdl-26996284
ABSTRACT
BACKGROUND AND OBJECTIVE:
Colonic anastomotic failure is a dreaded complication, and multiple surgical techniques have failed to eliminate it. Photochemical tissue bonding (PTB) is a method of sealing tissue surfaces by light-activated crosslinking. We evaluated if a human amniotic membrane (HAM), sealed over the anastomotic line by PTB, increases the anastomotic strength. STUDYDESIGN:
Sprague-Dawley rats underwent midline laparotomy followed by surgical transection of the left colon. Animals were randomized to colonic anastomosis by one of the following methods (20 per group) single-layer continuous circumferential suture repair (SR); SR with a HAM wrap attached by suture (SR+ HAM-S); SR with HAM bonded photochemically over the anastomotic site using 532 nm light (SR+ HAM-PTB); approximation of the bowel ends with only three sutures and sealing with HAM-PTB (3+ HAM-PTB). A control group underwent laparotomy alone with no colon resection (NR). Sub-groups (n = 10) were sacrificed at days 3 and 7 post-operatively and adhesions were evaluated. A 6 cm section of colon was then removed and strength of anastomosis evaluated by burst pressure (BP) measurement.RESULTS:
A fourfold increase in BP was observed in the SR+ HAM-PTB group compared to suture repair alone (94 ± 3 vs. 25 ± 8 mm Hg, P < 0.0001) at day 3. At day 7 the burst pressures were 165 ± 40 and 145 ± 31 mm Hg (P = 1), respectively. A significant decrease in peri-anastomotic adhesions was observed in the SR+ HAM-PTB group compared to the SR group at both time points (P < 0.001).CONCLUSION:
Sealing sutured colonic anastomotic lines with HAM-PTB increases the early strength of the repair and reduces peri-anastomotic adhesions. Lasers Surg. Med. 48530-537, 2016. © 2016 Wiley Periodicals, Inc.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Fotoquimioterapia
/
Aderências Teciduais
/
Colo
/
Fístula Anastomótica
/
Técnicas de Fechamento de Ferimentos
/
Âmnio
Tipo de estudo:
Clinical_trials
/
Etiology_studies
Limite:
Animals
/
Humans
Idioma:
En
Revista:
Lasers Surg Med
Ano de publicação:
2016
Tipo de documento:
Article