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International Journal of Colorectal Disease

Published in:

01-04-2014 | Original Article

Impact of intraoperative temperature and humidity on healing of intestinal anastomoses

Authors: Torben Glatz, Johannes Boldt, Sylvia Timme, Birte Kulemann, Gabriel Seifert, Philipp Anton Holzner, Sophia Chikhladze, Jodok Matthias Grüneberger, Simon Küsters, Olivia Sick, Jens Höppner, Ulrich Theodor Hopt, Goran Marjanovic

Published in: International Journal of Colorectal Disease | Issue 4/2014

Abstract

Purpose

Clinical data indicate that laparoscopic surgery has a beneficial effect on intestinal wound healing and is associated with a lower incidence of anastomotic leakage. This observation is based on weak evidence, and little is known about the impact of intraoperative parameters during laparoscopic surgery, e.g., temperature and humidity.

Methods

A small-bowel anastomosis was formed in rats inside an incubator, in an environment of stable humidity and temperature. Three groups of ten Wistar rats were operated: a control group (G1) in an open surgical environment and two groups (G2 and G3) in the incubator at a humidity of 60 % and a temperature of 30 and 37 °C (G2 and G3, respectively). After 4 days, bursting pressure and hydroxyproline concentration of the anastomosis were analyzed. The tissue was histologically examined. Serum levels of C-reactive-protein (CRP) were measured.

Results

No significant changes were seen in the evaluation of anastomotic stability. Bursting pressure was very similar among the groups. Hydroxyproline concentration in G3 (36.3 μg/g) was lower by trend (p = 0.072) than in G1 (51.7 μg/g) and G2 (46.4 μg/g). The histological evaluation showed similar results regarding necrosis, inflammatory cells, edema, and epithelization for all groups. G3 (2.56) showed a distinctly worse score for submucosal bridging (p = 0.061) than G1 (1.68). A highly significant increase (p = 0.008) in CRP was detected in G3 (598.96 ng/ml) compared to G1 (439.49 ng/ml) and G2 (460 ng/ml).

Conclusion

A combination of high temperature and humidity during surgery induces an increased systemic inflammatory response and seems to be attenuating the early regeneration process in the anastomotic tissue.

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Title: Impact of intraoperative temperature and humidity on healing of intestinal anastomoses
Authors: Torben Glatz
Johannes Boldt
Sylvia Timme
Birte Kulemann
Gabriel Seifert
Philipp Anton Holzner
Sophia Chikhladze
Jodok Matthias Grüneberger
Simon Küsters
Olivia Sick
Jens Höppner
Ulrich Theodor Hopt
Goran Marjanovic
Publication date: 01-04-2014
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 4/2014
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-014-1832-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Impact of intraoperative temperature and humidity on healing of intestinal anastomoses

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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