Leakage of colon anastomoses: development of an experimental model in pigs.

Abstract

BACKGROUND: In order to investigate anastomotic leakage, a number of experimental animal studies have been previously carried out. Due to the low frequency of spontaneous anastomotic leakages, there have been studies on gastrointestinal anastomoses with iatrogenically produced leakages. A leakage model has only been developed in one gastric bypass study. The aim of the present study was to develop a leakage model of pig colon anastomoses. This type of study has never been performed before. MATERIALS AND METHODS: Anastomosis was performed in 22 pigs. In all anastomoses a standardized rupture in the anastomotic line was made. The rupture ranged from 5 mm in the first group of pigs, increasing subsequently to 21 mm in the last group. Autopsy was performed after 7 days. The end points were macroscopic leakage and fecal peritonitis. RESULTS: 6 out of the 6 pigs with a 21-mm rupture developed leakage and fecal peritonitis. In the groups with smaller ruptures, most of the pigs did not develop any signs of leakage or fecal peritonitis. The difference is significant. The group of pigs with peritonitis had significantly fewer adhesions to the anastomoses than the group without peritonitis. CONCLUSION: A model of anastomotic leakage on pig colon is developed with creation of a 21-mm rupture in the anastomotic line.