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Experimental fortification of intestinal anastomoses with nanofibrous materials in a large animal model
J. Rosendorf, J. Horakova, M. Klicova, R. Palek, L. Cervenkova, T. Kural, P. Hosek, T. Kriz, V. Tegl, V. Moulisova, Z. Tonar, V. Treska, D. Lukas, V. Liska,
Language English Country Great Britain
Document type Journal Article, Research Support, Non-U.S. Gov't
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- MeSH
- Tissue Adhesions etiology prevention & control MeSH
- Anastomosis, Surgical MeSH
- Duodenum surgery MeSH
- Wound Healing MeSH
- Microscopy, Electron, Scanning MeSH
- Disease Models, Animal MeSH
- Random Allocation MeSH
- Nanofibers therapeutic use ultrastructure MeSH
- Peritoneal Diseases etiology prevention & control MeSH
- Anastomotic Leak prevention & control MeSH
- Polyesters MeSH
- Swine MeSH
- Materials Testing MeSH
- Tissue Scaffolds * MeSH
- Animals MeSH
- Check Tag
- Male MeSH
- Female MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
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 its' positive effects.
Biomedical Center Faculty of Medicine in Pilsen Charles University Prague Czech Republic
Department of Surgery Faculty of Medicine in Pilsen Charles University Prague Czech Republic
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- $a Rosendorf, Jachym $u Department of Surgery, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic. jachymrosendorf@gmail.com. Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic. jachymrosendorf@gmail.com.
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- $a 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 its' positive effects.
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