Protective effect of intraluminal fecal diverting device against colonic wall erosion induced by wrapping bands: A post-hoc pathological analysis
Sung Il Kang1
, Sohyun Kim1, Mi Jin Gu2, Jae Hwang Kim1
1Department of Surgery, Yeungnam University Faculty of Medicine, Yeungnam University Medical Center, Daegu, South Korea
2Department of Pathology, Yeungnam University Faculty of Medicine, Yeungnam University Medical Center, Daegu, South Korea
Abstract
Objective: Materials wrapping the bowel elicits tissue erosion gradually. We experienced several bowel wall erosions with no serious clinical consequences in our two previous animal experiments aimed at the safety and efficacy of the COLO-BT developed for intra-luminal fecal diversion. We tried to find out why the erosion is safe by investigating histologic changes of the tissue.
Material and Methods: Tissue slides at the COLO-BT fixing area from the subjects which had COLO-BT over three weeks acquired from our two previous animal experiments were reviewed. For the classification of the histologic change, microscopic findings were classified for six stages (from minimal change of stage 1 to severe change of stage 6).
Results: A total of 26 slides of 45 subjects were reviewed in this study. Five subjects (19.2%) had stage 6 histological change; three of stage 1 (11.5%), four of stage 2 (15.4%), six of stage 3 (23.1%), three of stage 4 (11.5%), and five of stage 5 (19.2%). All subjects which had a stage 6 histologic change survived. The phenomenon from which the back of the band is passed through is replaced by a relatively stable tissue layer due to fibrosis of the necrotic cells in the stage 6 histologic change.
Conclusion: We found that thanks to the sealing effect of the newly replaced layer, no leakage of the intestinal content occurs even if perforation by erosion develops according to this histologic tissue evaluation.
Keywords: Colonic wall erosion, foreign body, mesh, COLO-BT
Cite this article as: Kang II S, Kim S, Gu MJ, Kim JH. Protective effect of intraluminal fecal diverting device against colonic wall erosion induced by wrapping bands: A post-hoc pathological analysis. Turk J Surg 2022; 38 (4): 368-374.
It is only a retrospective review of the histological slides obtained from two previous animal studies, which were already published in peer-reviewed journals. Thus, a new ethical approval was not obligatory.
Externally peer-reviewed.
Concept – SK, JHK; Design – MJG, JHK; Supervision – MJG, JHK; Materials - SK, MJG, JHK; Data Collection and/ or Processing – SK, MJG, JHK; Analysis and/or Interpretation – SK, SK, MJG; Literature Search – SK, SK; Writing Manuscript – SK, SK, MJG; Critical Reviews – All of authors.
The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.
The authors declared that this study has received no financial support.