Effects of an intra-abdominal latex (drain-like) tube on anastomotic resistance and adhesion formation in a rat model

Abstract

PURPOSE: Aim of the present study was to determine effect of a latex drain on colonic resistance and its relation to adhesion phenomena. METHODS: Forty Sprague-Dawley rats were divided into two groups (n=20): Group 1, simple colonic anastomosis; and Group 2, colonic anastomosis with drain“ad latum.”Rats were sacrificed four days after surgery, and adhesions were evaluated. Segment containing anastomosis was removed, and bursting pressure was determined. RESULTS: General adhesion scores in Group 2 were higher than in Group 1 (P=0.002). Score for adhesions to anastomotic line in Group 1 was higher than in Group 2 (P=0.016). Bursting pressure was significantly lower in Group 2 (Group 1, 67.90±31.39 mmHg; Group 2, 46.95±29.69 mmHg;P=0.034). In all cases, leakage of dye was observed at the anastomotic line. A multiple regression test was applied to both groups (40 cases), taking bursting pressure as the dependent variable and other parameters as independent variables. A strong relationship appeared to exist between anastomotic resistance and fraction of anastomotic line that was covered by the neighboring organ (P<0.001). CONCLUSIONS: Placing a latex drain near a colonic anastomosis is associated with local inhibition of spontaneous adhesions to anastomotic line and, therefore, to significantly decreased resistance.