Journal Article

Experimental fortification of intestinal anastomoses with nanofibrous materials in a large animal model

Tegl, Vaclav, Treska, Vladislav, Palek, Richard, Cervenkova, Lenka, Liska, Vaclav, Moulisova, Vladimira, Klicova, Marketa, Kural, Tomas, Hosek, Petr, Kriz, Tomas, Lukas, David, Rosendorf, Jachym, Horakova, Jana, Tonar, Zbynek

2020

Overview

Anastomotic leakage is a severe complication in gastrointestinal surgery. It is often a reason for reoperation together with intestinal passage blockage due to formation of peritoneal adhesions. Different materials as local prevention of these complications have been studied, none of which are nowadays routinely used in clinical practice. Nanofabrics created proved to promote healing with their structure similar to extracellular matrix. We decided to study their impact on anastomotic healing and formation of peritoneal adhesions. We performed an experiment on 24 piglets. We constructed 3 hand sutured end-to-end anastomoses on the small intestine of each pig. We covered the anastomoses with a sheet of polycaprolactone nanomaterial in the first experimental group, with a sheet of copolymer of polylactic acid with polycaprolactone in the second one and no fortifying material was used in the Control group. The animals were sacrificed after 3 weeks of observation. Clinical, biochemical and macroscopic signs of anastomotic leakage or intestinal obstruction were monitored, the quality of the scar tissue was assessed histologically, and a newly developed scoring system was employed to evaluate the presence of adhesions. The material is easy to manipulate with. There was no mortality or major morbidity in our groups. No statistical difference was found inbetween the groups in the matter of level of peritoneal adhesions or the quality of the anastomoses. We created a new adhesion scoring system. The material appears to be safe however needs to be studied further to prove itsʹ positive effects.

• Publisher: Nature Publishing Group UK,Nature Publishing Group
• Subject: 631/61/54/993 / 692/308/1426 / Abdomen / Anastomosis, Surgical / Anastomotic Leak - prevention & control / Animal models / Animals / Disease Models, Animal / Duodenum - surgery / Extracellular matrix / Female / Humanities and Social Sciences / Leakage / Male / Materials Testing / Medical research / Medicine / Microscopy, Electron, Scanning / Morbidity / multidisciplinary / Nanofibers - therapeutic use / Nanofibers - ultrastructure / Nanomaterials / Peritoneal Diseases - etiology / Peritoneal Diseases - prevention & control / Peritoneum / Polycaprolactone / Polyesters / Polylactic acid / Polymers / Radiation therapy / Random Allocation / Science / Science (multidisciplinary) / Small intestine / Surgery / Swine / Tissue Adhesions - etiology / Tissue Adhesions - prevention & control / Tissue Scaffolds / Wound Healing