An intraluminal prothesis may improve healing of a one-layer colonic anastomosis: An experimental study in pigs

Objective: To compare healing of one-layer colonic anastomoses with or without a soluble intraluminal prothesis (* SBS-tube(R)). Design: Randomised, partly blinded controlled study. Setting: University hospital. Denmark. Subjects: 16 female Danish country strain pigs, of which 8 had the SBS tube inserted and 8 acted as controls. Interventions: One-layer colonic anastomoses either hand-sewn (n = 8. controls) or hand-sewn onto an SBS tube (17 = 8). Main outcome measures: Macroscopic evaluation. leakage test. breaking strength, histology. oxygen tension in and near the anastomosis peroperatively and 4 days postoperatively. Results: Three quarters of the tubes (n = 8) dissolved in less than 2 hours. Histological examination showed significantly better structured layers and more mucosal epithelial covering in the SBS group. The other histological variables examined were: tissue gap (p < 0.08), inflammation (p < 0.10). breaking strength (p < 0.46) and amount of granulation tissue (p < 0.71), but the last findings were not significant. Oxygen tension at the anastomotic line was better in the SBS tube group. but not significantly so. Conclusions: We conclude that the SBS tube facilitates the sewing of the anastomosis and may improve healing. possibly because of better apposition of the cut ends and reduced tension in the sutures.