The Effect of Mechanical Bowel Preparation on Colonic Anastomotic Healing: an Experimental Study

Abstract

Purpose: Although bowel preparation is traditionally used in elective colorectal surgery, its value is debatable. The aim of this study was to evaluate the influence of mechanical bowel preparation on healing of colonic anastomoses.Material and Methods: Twenty-seven rats were divided into three groups, each of nine animals. All rats had left colonic resection and anastomosis. Group 1 and group 2 were the control and sham group, respectively. Group 3 had colonic lavage before resection and anastomosis. On the fourth postoperative day, animals were killed; bursting pressure and tissue hydroxyproline concentrations were measured and compared.Results: The median bursting pressure values were 87 (range 4–135) mmHg in group 1, 88 (range 78–136) mmHg in group 2 and 76.0 (range 57.0-125) mmHg in group 3. The differences between bursting pressure values of the groups were not statistically significant (p= 0.07). The median tissue hydroxyproline concentrations were 3.25 (range 2.635.16) mg/mg in group 1, 4.15 (range 1.54-5.72) mg/mg in group 2 and 3.52 (range 2.04-5.27) mg/mg in group 3. The differences between tissue hydroxyproline concentrations of the groups were not statistically significant (p = 0.7). Conclusion: Mechanical bowel preparation is not necessary for enhancing colonic anastomotic integrity in the rat.