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Experimental evaluation of a bovine pericardium‐derived collagen matrix buttress in ileocolic and colon anastomoses
Author(s) -
Gaertner Wolfgang B.,
Hagerman Gonzalo F.,
Potter Michael J.,
Karulf Richard E.
Publication year - 2010
Publication title -
journal of biomedical materials research part b: applied biomaterials
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.665
H-Index - 108
eISSN - 1552-4981
pISSN - 1552-4973
DOI - 10.1002/jbm.b.31488
Subject(s) - anastomosis , medicine , surgery , descending colon , anatomy , rectum
Background: Anastomotic leakage is a major complication of colorectal surgery. The purpose of this study was to evaluate and compare stapled ileocolic and colon‐colon anastomoses with or without a collagen buttress derived from bovine pericardium in the immediate postoperative period. Methods: Various stapling devices were used to create ileocolic and colon‐colon anastomoses in a canine model. Ileocolic anastomoses were created by simulating two different techniques: “open” and “laparoscopic”. Colon‐colon anastomoses were created by using a double‐stapled technique. A total of 27 colon anastomoses (13 left colon‐colon, 8 right “laparoscopic”, and 6 right “open”) were created. Anastomoses buttressed with bovine pericardium ( n = 15) were compared to anastomoses without any reinforcement ( n = 12). Staple lines were evaluated 4 hours after operation. Evaluation included bursting pressure and bursting location. Results: No stapler device malfunction occurred. Excision rings were complete in all colon‐colon anastomoses. All non‐buttressed anastomoses burst at the staple line, whereas with buttressed anastomoses the adjacent intestine burst ( p = 0.0001). The intestinal bursting pressure of bowel segments with buttressed staple lines (mean, 362 mmHg) was significantly higher than the bursting pressure of non‐buttressed staple lines (mean, 204 mmHg, p < 0.0001). Conclusion: The use of a collagen matrix buttress derived from bovine pericardium in stapled ileocolic and colon‐colon anastomoses was safe. Buttressed anastomoses showed greater bursting strength as compared to non‐buttressed anastomoses in the immediate postoperative period in a canine model. © 2009 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2010