Pathogenesis and prevention of disruption of colonic anastomoses in traumatized rats

Abstract

Colonic operations complicated by excessive intra-abdominal trauma are followed by a high incidence of anastomotic disruption. Experimental studies have shown that the local effects of trauma result in impaired colonic healing and a significant incidence of disruption in colonic anastomoses. The nature of the effect of local trauma on the healing of colonic anastomoses was studied in rats subjected to intra-abdominal trauma. The incidence of anastomotic disruption in traumatized rats was 18·5 per cent, but disruption did not occur when the colon was defunctioned for 4 weeks prior to surgery, and the incidence of anastomotic disruption in animals given intraperitoneal cephalothin during surgery was only 3·6 per cent. It was concluded that sepsis is the immediate cause of anastomotic disruption in traumatized rats, and it was suggested that the value of prophylactic intraperitoneal antimicrobial therapy in patients undergoing colonic surgery should be studied in a randomized prospective clinical trial.