A new porcine model for the study of high-risk colonic anastomoses due to hypoperfusion

Author: 
Carlos Garcia-Vasquez., Maria Fernandez-Aceñero., David De-Pablo., Maria Garcia Gomez de las Heras., Patricia Tejedor and Carlos Pastor

Gastrointestinal anastomosis is a common procedure, leakage brings a significant increase in mortality and morbidity (Kofoed SC et al., 2014). Multiple animals models have being proposed for the study of the anastomosis leakage, the pig is one of the most appropriate. We present a new model of high-risk colo-ileal anastomosis, conditioned by hypo-perfusion of the cecum. After 5 days the anastomosis were recovered. A 30% rate of anastomosis failure was found. We think that our model is effective for the study of ischemia effects on intestinal anastomosis and may be a way of reducing the number of subjects needed on studies. Introduction: The suture failure in intestinal surgery known as anastomotic leakage is a serious complication resulting in a significant increase of postoperative complications and mortality. The incidence of anastomotic leakage depends on several conditions such the quality of the surgical technique, the patient´sconditions and whether if the suture in made involving the colon or the rectum with fecal contamination.
Methods: We present a novel experimental model of anastomotic leakage on pigs by performing a high-risk ileocolic suture on pigs. With the aim to create an isquemic condition by a selective ligation of the marginal vesselsof a 5-10 cm. segment of colon at the cecum level. Afterwards, we performed a standardized hand-sewn anastomosis between the ileum and the hypovascularized colon. On the 5th postoperative day the animals were euthanaized and the anastomosiswere reviewed by the same surgeons. We designed the experimental model expecting a 10% incidence of anastomotic leakage s.
Results: Ten cases were included in this observational prospective study. At the second surgery e observeda 30% rate of clinically significant anastomosis leakage.
Conclusions: With the present experimental model we have validated a simple and feasible novel model in colonic surgeriesfor testing anastomotic failures.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2018.14108.2546
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