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THE JOURNAL OF CARDIOVASCULAR SURGERY

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The Journal of Cardiovascular Surgery 2000 Giugno;41(3):479-81

lingua: Inglese

Latex rubber (Penrose drain) is detrimental to esophagogastric anastomotic healing in rats

Cui Y., Urschel J. D.

From the Department of Thoracic Surgery Roswell Park Cancer Institute State University of New York at Buffalo, Buffalo, New York, USA


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Background. Surgeons com­mon­ly ­drain cer­vi­cal eso­phag­o­gas­tric anas­to­mos­es, but ­there is lit­tle objec­tive evi­dence to sup­port ­this prac­tice. Studies in oth­er are­as of gas­troin­tes­ti­nal sur­gery ­have ­shown ­that rou­tine drain­age is unnec­es­sary, and ­even det­ri­men­tal to anas­to­mot­ic heal­ing. We con­duct­ed an ani­mal experi­ment to see if a ­drain had a neg­a­tive ­effect on eso­phag­o­gas­tric anas­to­mot­ic heal­ing.
Methods. Esophagogastric anas­to­mos­es ­were ­done in 40 ­rats. In the experi­men­tal ­group (20 ­rats) a por­tion of ­latex rub­ber Penrose ­drain was ­placed ­over the anas­tom­o­sis. This was not ­done in the con­trol ­group (20 ­rats). Rats ­were sac­ri­ficed 7 ­days ­after sur­gery. The anas­to­mos­es ­were inspect­ed for ­leaks, dis­tract­ed in a ten­sio­me­ter to meas­ure break­ing ­strength, and sub­ject­ed to hydrox­y­pro­line anal­y­sis (an indi­ca­tor of ­wound col­la­gen).
Results. There ­were 4 con­tained ­leaks in the experi­men­tal ­group (­drain) and no ­leaks in the con­trol ­rats (p=0.033). Anastomotic break­ing ­strength was 3.80±0.81 N in the experi­men­tal ­rats and 3.46±0.64 N in the con­trol ­rats (p=0.18, not sig­nif­i­cant). Anastomotic tis­sue hydrox­y­pro­line con­cen­tra­tion was 615.9±52 ­nmol/mg in the experi­men­tal ­rats and 609.4±195 ­nmol/mg in the con­trol ­rats (p=0.13, not sig­nif­i­cant).
Conclusions. The pres­ence of ­drain mate­ri­al pre­dis­posed to eso­phag­o­gas­tric anas­to­mot­ic leak­age in ­this rat mod­el.

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