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首页> 外文期刊>International journal of colorectal disease. >No detrimental effects of repeated laparotomies on early healing of experimental intestinal anastomoses.
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No detrimental effects of repeated laparotomies on early healing of experimental intestinal anastomoses.

机译：重复开腹手术对实验性肠吻合术的早期愈合没有不利影响。

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BACKGROUND: Little is known about the impact of repeated laparotomies on intestinal anastomotic healing. While experimental data are completely lacking, the sparse data available from clinical studies report high anastomotic failure rates, suggesting a negative effect in this respect. Since the unequivocal determination of such an effect may have important consequences for choosing the optimal treatment strategy for patients suffering from intra-abdominal infection, an experimental study has been performed in an established rodent model. METHODS: Intestinal anastomoses were constructed in healthy Wistar rats (ileal and colonic anastomoses) or 24 h after peritonitis was induced by caecal ligation and puncture (colonic anastomosis only). Rats were then scheduled to undergo no, one (after 24 h) or two relaparotomies (after 24 and 48 h). Anastomotic strength was assessed 3 and 5 days after anastomotic construction. On the third post-operative day anastomotic hydroxyproline levels, matrix metalloproteinase activity and myeloperoxidase activity were measured. RESULTS: No negative impact of repeated laparotomies was measured on any of the parameters measured. Under non-infectious conditions even an improvement in breaking strength (+48%, p=0.017) but not bursting pressure was found after two relaparotomies, but only in the ileum on the third post-operative day. CONCLUSIONS: In this experimental setting, early anastomotic healing is not adversely affected by repeated laparotomies.
机译：背景：关于重复开腹手术对肠吻合口愈合的影响知之甚少。虽然完全缺乏实验数据，但可从临床研究获得的稀疏数据报告了较高的吻合失败率，这表明在这方面有负面影响。由于明确确定这种作用可能会对选择适合腹腔内感染的患者的最佳治疗策略产生重要影响，因此已经在建立的啮齿动物模型中进行了实验研究。方法：在健康的Wistar大鼠（回肠和结肠吻合）中或在盲肠结扎和穿刺诱导腹膜炎后24小时（仅结肠结肠吻合）构建肠吻合。然后，将大鼠安排不进行任何一次，24小时后（24小时）或两次再手术（24小时和48小时后）。吻合后第3天和第5天评估吻合强度。术后第三天测量吻合羟脯氨酸水平，基质金属蛋白酶活性和髓过氧化物酶活性。结果：重复开腹手术未对任何测量参数产生负面影响。在非感染性条件下，两次开腹手术后，甚至在回肠中，甚至在回肠中也发现断裂强度有所改善（+ 48％，p = 0.017），但未发现破裂压力。结论：在该实验环境中，早期的吻合口愈合不会受到重复开腹手术的不利影响。

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