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Rosendorf J, Klicova M, Cervenkova L, Horakova J, Klapstova A, Hosek P, Palek R, Sevcik J, Polak R, Treska V, Chvojka J, Liska V. Reinforcement of Colonic Anastomosis with Improved Ultrafine Nanofibrous Patch: Experiment on Pig. Biomedicines 2021; 9:102. [PMID: 33494257 PMCID: PMC7909771 DOI: 10.3390/biomedicines9020102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/15/2021] [Accepted: 01/19/2021] [Indexed: 01/12/2023] Open
Abstract
Anastomotic leakage is a dreadful complication in colorectal surgery. It has a negative impact on postoperative mortality, long term life quality and oncological results. Nanofibrous polycaprolactone materials have shown pro-healing properties in various applications before. Our team developed several versions of these for healing support of colorectal anastomoses with promising results in previous years. In this study, we developed highly porous biocompatible polycaprolactone nanofibrous patches. We constructed a defective anastomosis on the large intestine of 16 pigs, covered the anastomoses with the patch in 8 animals (Experimental group) and left the rest uncovered (Control group). After 21 days of observation we evaluated postoperative changes, signs of leakage and other complications. The samples were assessed histologically according to standardized protocols. The material was easy to work with. All animals survived with no major complication. There were no differences in intestinal wall integrity between the groups and there were no signs of anastomotic leakage in any animal. The levels of collagen were significantly higher in the Experimental group, which we consider to be an indirect sign of higher mechanical strength. The material shall be further perfected in the future and possibly combined with active molecules to specifically influence the healing process.
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Affiliation(s)
- Jachym Rosendorf
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 301 00 Pilsen, Czech Republic; (L.C.); (P.H.); (R.P.); (J.S.); (R.P.)
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, 301 00 Pilsen, Czech Republic;
| | - Marketa Klicova
- Department of Nonwovens and Nanofibrous Materials, Faculty of Textile Engineering, Technical University of Liberec, 460 01 Liberec, Czech Republic; (M.K.); (J.H.); (A.K.); (J.C.)
| | - Lenka Cervenkova
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 301 00 Pilsen, Czech Republic; (L.C.); (P.H.); (R.P.); (J.S.); (R.P.)
| | - Jana Horakova
- Department of Nonwovens and Nanofibrous Materials, Faculty of Textile Engineering, Technical University of Liberec, 460 01 Liberec, Czech Republic; (M.K.); (J.H.); (A.K.); (J.C.)
| | - Andrea Klapstova
- Department of Nonwovens and Nanofibrous Materials, Faculty of Textile Engineering, Technical University of Liberec, 460 01 Liberec, Czech Republic; (M.K.); (J.H.); (A.K.); (J.C.)
| | - Petr Hosek
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 301 00 Pilsen, Czech Republic; (L.C.); (P.H.); (R.P.); (J.S.); (R.P.)
| | - Richard Palek
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 301 00 Pilsen, Czech Republic; (L.C.); (P.H.); (R.P.); (J.S.); (R.P.)
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, 301 00 Pilsen, Czech Republic;
| | - Jan Sevcik
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 301 00 Pilsen, Czech Republic; (L.C.); (P.H.); (R.P.); (J.S.); (R.P.)
| | - Robert Polak
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 301 00 Pilsen, Czech Republic; (L.C.); (P.H.); (R.P.); (J.S.); (R.P.)
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, 301 00 Pilsen, Czech Republic;
| | - Vladislav Treska
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, 301 00 Pilsen, Czech Republic;
| | - Jiri Chvojka
- Department of Nonwovens and Nanofibrous Materials, Faculty of Textile Engineering, Technical University of Liberec, 460 01 Liberec, Czech Republic; (M.K.); (J.H.); (A.K.); (J.C.)
| | - Vaclav Liska
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 301 00 Pilsen, Czech Republic; (L.C.); (P.H.); (R.P.); (J.S.); (R.P.)
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, 301 00 Pilsen, Czech Republic;
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Tagkalos E, Lindner A, Gruber G, Lang H, Heimann A, Grimminger PP, Muensterer OJ, Oetzmann von Sochaczewski C. Using simple interrupted suture anastomoses may impair translatability of experimental rodent oesophageal surgery. Acta Chir Belg 2020; 120:310-314. [PMID: 31012385 DOI: 10.1080/00015458.2019.1610263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background/purpose: Irreproducibility and missing translatability are major drawbacks in experimental animal studies. Hand-sewn anastomoses in oesophageal surgery are usually continuous, whereas those in experimental oesophageal surgery are widely performed using the simple interrupted technique. It has been implicated to be inferior in tolerating anastomotic tension, which we aimed to test in rats due to their importance as an animal model in oesophageal surgery.Methods: We determined linear breaking strengths for the native oesophagus (n = 10), the simple interrupted suture anastomosis (n = 11), and the simple stitch (n = 9) in 8-week old Sprague-Dawley rats. Experiments were powered to a margin of error of 10% around the results of exploratory investigations. The comparison of anastomotic resilience between native organ and simple interrupted suture anastomosis was a priori powered to 99%.Results: Native oesophagi sustained traction forces of 4.25 N (95% CI: 4.03-4.58 N), but the simple interrupted suture anastomosis had only 38.6% (Δ= -2.78 N, 95% CI: -2.46 to -3.11 N, p < .0001) of the resilience of native oesophagi.Conclusions: Oesophageal division and re-anastomosis markedly decreases resilience to traction forces compared to the native organ. This effect is even more pronounced in rats compared to other species and might impair transferability of results.
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Affiliation(s)
- Evangelos Tagkalos
- Department of General, Visceral and Transplant Surgery Universitätsmedizin Mainz der Johannes Gutenberg-Universität, Mainz, Germany
| | - Andreas Lindner
- Department of Paediatric Surgery, Universitätsmedizin Mainz der Johannes Gutenberg-Universität, Mainz, Germany
| | - Gudrun Gruber
- Translational Animal Research Centre Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Hauke Lang
- Department of General, Visceral and Transplant Surgery Universitätsmedizin Mainz der Johannes Gutenberg-Universität, Mainz, Germany
| | - Axel Heimann
- Institute of Neurosurgical Pathophysiology Universitätsmedizin Mainz der Johannes Gutenberg-Universität, Mainz, Germany
| | - Peter P. Grimminger
- Department of General, Visceral and Transplant Surgery Universitätsmedizin Mainz der Johannes Gutenberg-Universität, Mainz, Germany
| | - Oliver J. Muensterer
- Department of Paediatric Surgery, Universitätsmedizin Mainz der Johannes Gutenberg-Universität, Mainz, Germany
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