EFFECT OF INTRAOPERATIVE COLONIC IRRIGATION WITH VARIOUS SOLUTIONS ON THE ANASTOMOTIC HEALING IN ACUTE LEFT-SIDED LARGE BOWEL OBSTRUCTION

Abstract

The effect of intraoperative colonic irrigation with various solutions on the anastomotic healing in experimental left-sided colonic obstruction was investigated. After 24 hours of simple obstruction of the descending colon, segmental bowel resection and primary anastomosis was performed in male Sprague-Dawley rats. No cleansing was done in the control group. Prior to anastomosis, antegrade colonic lavage was performed with saline, polyethylene glycol, povidone, and metronidazole in other four groups. Seven days later anastomotic bursting pressure and hydroxproline concentration at the anastomotic segment was determined. Most bursting sites were extraanastomotic. Although bursting pressure was higher in irrigation groups than control differences were not significant. Hydroxproline concentrations was higher in irrigation groups than control but this was only significant in the saline group (p=0.025). In conclusion, intraoperative colonic irrigation with saline has positive effect on anastomotic healing in acute left-sided large bowel obstruction. Polyethylene glycol, povidone-iodine and metronidazole have no additional advantage on it.