Abstract
Objectives To determine whether early postoperative feeding attenuates the inhibitory effects of intestinal anastomosis in rabbits. Methods After undergoing gastrointestinal anastomosis, 48 rabbits were randomly divided into experimental and control groups. The rabbits in the experimental group were fed a liquid diet beginning 24 h postoperatively, while the control rabbits received only total parenteral nutrition after the operation. Exploratory laparotomies were performed on four rabbits in each group 3, 5, 7, 10, and 15 days postoperatively, and the healing rate of the anastomosis, anastomotic bursting pressure, anastomotic breaking strength, and hydroxyproline content at the anastomosis were determined. Results The anastomoses healed in 91.6% (22/24) of the control group and 95.8% (23/24) of the experimental group. The anastomotic bursting pressure decreased remarkably in both groups 3 days postoperatively, reaching the lowest value. The anastomotic breaking strength did not differ between the two groups 3 days postoperatively, when both reached their lowest points, and both groups increased markedly and peaked 10 days postoperatively. The hydroxyproline content of the anastomosis was slightly lower in the experimental group 3 days postoperatively, although both groups peaked 7 days postoperatively. Conclusions Early postoperative feeding does not increase the anastomosis healing time or rate of gastrointestinal anastomosis leakage.
Highlights
Gastrointestinal anastomosis is the most common gastrointestinal reconstruction surgery [1, 2]
The control group fasted after the operation, with water administered by intravenous infusion to maintain daily physiological requirements
Previous studies in rabbits that underwent esophageal anastomosis demonstrated the advantages of early rather than late postoperative feeding, this has not been confirmed in patients with gastrointestinal anastomosis
Summary
Gastrointestinal anastomosis is the most common gastrointestinal reconstruction surgery [1, 2]. A frequent complication after gastrointestinal anastomosis is gastrointestinal fistula formation, the incidence of which is 0–17.4% [3]. Anastomotic leakage is influenced by systemic factors, including diabetes, cirrhosis, and other chronic wasting diseases, which impair the body’s repair capacity as well as its ability to fight infections and healing of the anastomosis. Many studies have shown that patients with a poor nutritional status are more prone to complications. A positive correlation between preoperative weight loss and anastomotic fistula was reported [4]. Insufficient mobility of the anastomosis, excessive resection, and excessive tension on the anastomotic site compromise healing, as does an inadequate blood supply
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