Abstract:
BACKGROUND:Colorectal anastomoses created in a contaminated environment result in a high leakage rate. This study investigated whether using anastomotic sealants (TissuCol(®), Histoacryl(®) Flex, and Duraseal(®)) prevents leakage in a rat peritonitis model. STUDY DESIGN:Sixty-seven Wistar rats were divided into control and experimental groups (TissuCol, Histoacryl, and Duraseal groups). Peritonitis was induced 1 day before surgery with the cecal ligation puncture model. On day 0, colonic anastomosis was constructed with sutures and then sealed with no adhesive (control group) or one select adhesive (experimental groups). Bursting pressure, abscess formation, and adhesion severity were evaluated on day 3 or day 14. Hematoxylin and eosin staining and immunohistochemical staining for CD4, CD8, CD206, and iNOS were performed. RESULTS:On day 3, bursting pressures of the TissuCol group (120.1 ± 25.3 mmHg), Histoacryl group (117.3 ± 20.2 mmHg), and Duraseal group (123.6 ± 35.4 mmHg) were significantly higher than the that of the control group (24.4 ± 31.7 mmHg, p < 0.001). Abscesses around the anastomosis were found in the control group (6/7) and Duraseal group (2/9) but not in the TissuCol group or Histoacryl group. A higher number of CD206+ cells (M2 macrophages), a lower number of iNOS+ cells (M1 macrophages), a higher M2/M1 index, and a higher CD4+/CD8+ index were seen at the anastomotic site in all experimental groups compared with the control group on day 3. On day 14, abscesses were only found in the control group. Adhesion severity in the Duraseal group was significantly lower than that in the control group (p = 0.001). CONCLUSIONS:Anastomotic sealing using TissuCol(®), Histoacryl(®) Flex, or Duraseal(®) seems to be an effective and safe option to prevent leakage in contaminated colorectal surgery. The presence of large numbers of anti-inflammatory macrophages seems to be involved in preventing the leakage.
journal_name
Int J Colorectal Disjournal_title
International journal of colorectal diseaseauthors
Wu Z,Vakalopoulos KA,Boersema GS,Kroese LF,Lam KH,van der Horst PH,Mulder IM,Bastiaansen-Jenniskens YM,Kleinrensink GJ,Jeekel J,Lange JFdoi
10.1007/s00384-014-2012-xsubject
Has Abstractpub_date
2014-12-01 00:00:00pages
1507-16issue
12eissn
0179-1958issn
1432-1262journal_volume
29pub_type
杂志文章abstract:PURPOSE:Urinary retention is a common complication of pelvic surgery, leading to urinary tract infection and prolonged hospital stays. Tamsulosin is an alpha blocker that works by relaxing bladder neck muscles. It is used to treat benign prostatic hypertrophy and retention. We aim to investigate the potential benefits ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
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abstract::Emergency resections of obstructing colorectal carcinomas usually involve only limited rather than radical lymphadenectomy, which may contribute to the poor long-term survival of these patients. Thirty patients with ileus due to colorectal cancer have been included in a prospective follow-up study since January 1995. ...
journal_title:International journal of colorectal disease
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journal_title:International journal of colorectal disease
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journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
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journal_title:International journal of colorectal disease
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journal_title:International journal of colorectal disease
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journal_title:International journal of colorectal disease
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journal_title:International journal of colorectal disease
pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章,多中心研究
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journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
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pub_type: 杂志文章,随机对照试验
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更新日期:2009-04-01 00:00:00
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更新日期:2018-11-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
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journal_title:International journal of colorectal disease
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更新日期:2012-12-01 00:00:00
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