ORIGINAL ARTICLES  THORACIC SECTION 

The Journal of Cardiovascular Surgery 2003 December;44(6):775-8

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

The effect of tension on esophagogastric anastomotic wound healing in rats

Cui Y. ^{1, 2}, Chen H. ²

¹ Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, NY, USA 2 Department of Thoracic Surgery, First Hospital, Beijing University, Beijing, China

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Aim. The ­effect of ten­sion on the occur­rence of eso­phag­o­gas­tric anas­to­motic ­leaks has ­been con­tro­ver­sial for a ­long ­time. We ­used a rat ­model and inves­ti­gated the ­effect of ten­sion on the eso­phag­o­gas­tric anas­to­motic ­wound ­healing.
­Methods. ­Eighty ­Sprague-­Dawley ­rats ­were ­divided ­into 8 ­groups and ­each ­group has 10 ­rats. A ­side-to-­side ­single ­layer eso­phag­o­gas­tric anas­tom­osis was con­structed ­using inter­rupted ­sutures ­through lap­a­rotomy. Anas­to­moses ­were ­excised on day 0, 3, 5, 7, 14, ­mounted in an ­Instron ­mini-44 Ten­sion­meter and dis­tracted at 10 mm/min to ­measure ­breaking ­strength. On the ­other ­hand, the ­increased anas­to­motic ten­sions ­were ­obtained by ­increasing the dis­tance ­between esoph­a­geal inci­sion and gas­trotomy, and anas­to­motic ­leak ­rates in dif­ferent anas­to­motic ten­sion ­groups ­were inves­ti­gated.
­Results. A ­total of 11 ­rats ­were ­excluded ­from the ­studies ­because of pul­mo­nary com­pli­ca­tion. ­Breaking ­strength on day 0, 3, 5, 7, 14 ­were 3.35±0.89, 1.18±0.31, 1.92±0.46, 3.47±0.83, 5.06±1.22 (­Newton), respec­tively. The ­breaking ­strength is sig­nif­i­cantly dif­ferent ­between day 0 and day 3, day 5 and day 7, day 7 and day 14 (p<0.05). ­There is no dif­fer­ence ­between day 3 and day 5, day 0 and day 7 (p>0.05). ­Breaking ­strength is ­lowest on day 3 and ­close to cul­mi­na­tion on day 14. Eso­phag­o­gas­tric anas­to­motic ­leaks ­increased ­along ­with anas­to­motic ten­sion ­increasing.
Con­clu­sion. Anas­to­motic ten­sion ­could be a key ­factor ­resulting in eso­phag­o­gas­tric anas­to­motic ­leaks.