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Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632
Online ISSN 1827-191X
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
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.