A novel colonic anastomosis technique involving fixed polyglycolic acid mesh

Abstract

Background: Polyglycolic acid mesh (PAM) reinforcement of colonic anastomoses were evaluated.

Methods: Twenty female albino rabbits were divided into two groups. Each rabbit underwent segmental colonic resection with single-layer anastomosis. In one group of rabbits, PAM of length equal to the circumference of the anastomosis was applied. Rabbits were sacrificed on postoperative day 10 and peritoneal adhesions, anastomosis burst pressure, and anastomosis histopathological characteristics were evaluated.

Results: The average burst pressure for the control and PAM groups was 149±15.95 mmHgand 224±124.5 mmHg, respectively (p=0.578). All control anastomoses burst, whereas only five (50%) PAM anastomoses burst (p<0.03). There was no anastomotic leakage in the control group, whereas three PAM group anastomoses leaked (p=0.210). The collagen fiber density and amount of neovascularization were lower in the PAM than the control group (p=0.001 and p=0.002, respectively). The average peritoneal adhesion value was 1.6±0.51 in the control group and 2.9±0.31 in the PAM group (p<0.0001).

Conclusion: The new fixed PAM-reinforced anastomosis technique resulted in an increased risk of anastomosis leakage and peritoneal adhesion, but also higher in non-burst anastomoses.

Keywords: Anastomosis; colon; mesh; novel; polyglycolic acid; technique.

Figures

Figure 1

Mesh covered colonic anastomosis (anterior view).

Figure 2

Mesh covered colonic anastomosis (trans-sectional view).