THE EFFECT OF LOOP COLOSTOMY ON THE HEALING OF COLON ANASTOMOSIS IN RATS

Abstract

Diverting colostomy reduces collagen accumulation, and decreases or delays the gain in anastomotic strength due to absence of intraluminal transit. As for loop colostomy, intact mesenteric side maintains the integrity of myoelectric activity, which in turn promotes to collagen synthesis. With these background information, the healing of colon anastomosis following loop colostomy comparing with diverting colostomy was investigated. Thirty rats were divided into three equal groups. Following colon resection Group I had colon anastomosis only, Group II had colon anastomosis and diverting colostomy, and Group III colon anastomosis and loop colostomy. On the seventh postoperative day, anastomotic bursting pressures and tissue hydroxyproline levels in anastomotic segments of all subjects were determined. Bursting pressures of anastomoses in Group I was higher than in Group II and III (p=0.0024, one-way ANOVA), Tissue hydroxyproline levels in Group II were lower than in Group I and III (p<0.0001, one-way ANOVA). Although anastomotic strength decreases in loop colostomy, collagen accumulation similar to the levels of anastomoses without colostomy may be due to a delay in collagen maturation. Loop colostomy may be preferred to prevent anastomoses with minimal effects on healing.