Protection of Intestinal Anastomoses in Septic Environment With Peritoneal Graft and Polyglycolic Acid Mesh: an Experimental Study

Abstract

We carried out an experimental study in dogs to evaluate the outcome of large bowel anastomosis with 6 stitches (Group C, n:6) in a septic environment with protection by a polyglycolic acid (PGA) mesh (Group M, n:12) or peritoneal graft (Group P, n:12). Thirty dogs were used to compare the techniques. Two dogs in each group were re-operated after 3, 5, 7, 14, 28 and 90 days. They were evaluated for adhesion formation, lumen diameter (anastomotic index), clinical features, histologic appearance and quality of healing at the anastomotic sites. All dogs in group P and group M survived, whereas 2 dogs in the control group died of anastomotic leakage and 3 dogs were re-operated for anastomotic leakage and peritonitis. In group M, one dog was reoperated because of the anastomotic leakage and two dogs were reoperated because of the anastomotic stenosis. Also, 4 anastomoses showed evidence of moderate stenosis. In group P, three anastomoses were graded as minimal stenosis. Histopathologic evaluation showed more complete epithelization, less inflammation, and less adhesion in group P than group M. We could not find any study in the literature that described and compared both techniques. We report here the results of such a study.