Document Detail

Effect of persistently elevated intraabdominal pressure on healing of colonic anastomoses.
MedLine Citation:
PMID:  10587186     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The adverse effects of elevated intraabdominal pressure (IAP) on abdominal organs are realized, but its influence on anastomotic healing has not been studied. The aim of this study was to evaluate the effect of elevated IAP on healing of colonic anastomoses. METHODS: Thirty rats, which all had right colonic anastomoses, were divided into five groups. Group 1 was the control group, and group 2 had fecal peritonitis. IAP was maintained between 4 to 6 mm Hg in group 3, 8 to 12 mm Hg in group 4, and 14 to 18 mm Hg in group 5 until all rats were sacrificed on day 4. Bursting pressures and tissue hydroxyproline concentrations of anastomoses were then analyzed and compared. RESULTS: Mean +/- SEM of bursting pressures were 143+/-2.9 mm Hg in group 1, 72+/-14.4 mm Hg in group 2, 77.3+/-7.9 mm Hg in group 3, 57.5+/-11.2 mm Hg in group 4, and 40.1+/-9.6 mm Hg in group 5 (P<0.0001, one-way analysis of variance [ANOVA]). Mean +/- SEM of tissue hydroxyproline concentrations were 5.3+/-0.3 microg/mg in group 1, 4.7+/-0.5 microg/mg in group 2, 4.6+/-0.6 microg/mg in group 3, 3.6+/-0.5 microg/mg in group 4, and 2.4+/-0.2 microg/mg in group 5 (P = 0.0026, one-way ANOVA). The bursting pressure and hydroxyproline concentrations had good correlation (P<0.001, r = 0.76). CONCLUSIONS: Elevated IAP delays healing of colonic anastomoses and 4 to 6 mm Hg IAP delays healing as much as fecal peritonitis. More elevated IAP delays healing more than fecal peritonitis. These events may be clinically important and may result from local-systemic effects of IAP.
M Kologlu; I Sayek; L B Kologlu; D Onat
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  178     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-12-15     Completed Date:  1999-12-15     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  293-7     Citation Subset:  AIM; IM    
Department of General Surgery, Hacettepe University Medical School, Ankara, Turkey.
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MeSH Terms
Abdomen / physiology*
Anastomosis, Surgical
Colon / surgery*
Hydroxyproline / analysis
Peritonitis / physiopathology
Postoperative Period
Rats, Wistar
Wound Healing / physiology*
Reg. No./Substance:

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