Kolon anastomozlarında dual meş ve polipropilen meş kullanımının anastomoz güvenliği üzerine etkisi
Küçük Resim Yok
Tarih
2015
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Kolon anastomoz kaçakları cerrahide önemli morbidite ve mortalite nedenleridir. Bu nedenle konvansiyonel metotla yapılan kolokolonik anastomozların üzerinin dual yama ile sarılmasının, anastomoz iyileşmesi ve güvenliği üzerine etkisini deneysel olarak ortaya koymayı amaçladık. Çalışma Trakya Üniversitesi Tıp Fakültesi Deney Hayvanları Araştırma Birimi'nde yapıldı. Yirmi adet, Wistar Albino cinsi, erişkin rat kullanıldı. Ratlar, kontrol ve dual yama grubu olacak şekilde 10'arlı gruplara ayrıldı. Tüm ratlara parsiyel segmenter kolon rezeksiyonu yapıldı ve 5/0 polipropilen ile tek kat kolokolonik anastomoz uygulandı. Dual yama grubundaki ratlarda, anastomozun üzeri; genişliği 1 cm, uzunluğu anastomoz çevresi kadar olan dual yama ile sarıldı. Kontrol grubunda ise anastomoz üzerine herhangi bir işlem yapılmadı. İşlem sonrası 7. günde tüm ratlara laparotomi yapılarak daha önceden hazırlanan düzenekler ile Evans Modeli'ne göre peritoneal adezyon derecesi ve kolon patlama basıncına bakıldı. Bunun yanısıra anastomoz bölgesi perianastomotik dokunun histopatolojik incelemesi yapıldı. İnceleme sonucunda kolokolonik anastomoz yapılan ratlarda; anastomoz hattının dual yama ile sarılmasının, anastomoz hattı patlama basıncını istatistiksel olarak anlamlı oranda yükselttiği (p<0,05), anastomoz hattında kollajen miktarını istatistiksel olarak anlamlı oranda arttırdığı (p<0,05), batın içi yapışıklıklarda da istatistiksel olarak anlamlı oranda azalmaya neden olduğu bulundu (p<0,05). Sonuç olarak, kolokolonik anastomoz hattının dual yama ile sarılması, batın içi yapışıklığa sebep olmaksızın, anastomoz patlama basıncını yükselterek anastomoz güvenliğini artırır.
Colon anastomotic leakage is the cause of significant morbidity and mortality in surgery. Therefore, the conventional method of wrapping them colocolonic anastomosis performed by dual patch, the effect on anastomotic healing and security, we aimed to demonstrate experimentally. The study was conducted at Trakya University Medical Faculty of Experimental Animal Research Unit. 20 Wistar Albino adult rats were used. Rats from control and 10 animals were divided into groups so that the dual patch group. All rats underwent partial segmental colon resection and colocolonic anastomosis was performed in a single layer with 5/0 polypropylene. Dual patch rats in groups over the anastomosis; width of 1 cm in length was wrapped up with dual patch anastomosis environment. In the control group there is no operation on the anastomosis. 7 days after the procedure, the degree of peritoneal adhesion model with previously prepared according to Evans devices laparotomy was looking at all the rats and colon burst pressure. The histopathological examination was performed as well as touch peri anastomotic area. In the study conducted in rats results colo-colonic anastomosis; the wrapping of the dual patch of anastomosis, anastomotic line burst pressure by increasing statistically significantly (p <0.05), the anastomosis in increased collagen amount statistically significantly (p <0.05), abdominal adhesions in a statistically significantly decreased was found to result (p <0.05). As a result, the colocolonic anastomosis of winding dual patch, without causing intraabdominal adhesions, improves security by increasing the anastomosis bursting pressure.
Colon anastomotic leakage is the cause of significant morbidity and mortality in surgery. Therefore, the conventional method of wrapping them colocolonic anastomosis performed by dual patch, the effect on anastomotic healing and security, we aimed to demonstrate experimentally. The study was conducted at Trakya University Medical Faculty of Experimental Animal Research Unit. 20 Wistar Albino adult rats were used. Rats from control and 10 animals were divided into groups so that the dual patch group. All rats underwent partial segmental colon resection and colocolonic anastomosis was performed in a single layer with 5/0 polypropylene. Dual patch rats in groups over the anastomosis; width of 1 cm in length was wrapped up with dual patch anastomosis environment. In the control group there is no operation on the anastomosis. 7 days after the procedure, the degree of peritoneal adhesion model with previously prepared according to Evans devices laparotomy was looking at all the rats and colon burst pressure. The histopathological examination was performed as well as touch peri anastomotic area. In the study conducted in rats results colo-colonic anastomosis; the wrapping of the dual patch of anastomosis, anastomotic line burst pressure by increasing statistically significantly (p <0.05), the anastomosis in increased collagen amount statistically significantly (p <0.05), abdominal adhesions in a statistically significantly decreased was found to result (p <0.05). As a result, the colocolonic anastomosis of winding dual patch, without causing intraabdominal adhesions, improves security by increasing the anastomosis bursting pressure.
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Genel Cerrahi, General Surgery
