Effects of Warmed and Humidified CO Surgical Site Insufflation in a Novel Experimental Model of Magnetic Compression Colonic Anastomosis.
Fiche publication
Date publication
octobre 2020
Journal
Surgical innovation
Auteurs
Membres identifiés du Cancéropôle Est :
Dr LINDNER Véronique, Pr MARESCAUX Jacques, Pr NAMER Izzie-Jacques
Tous les auteurs :
Marchegiani F, Noll E, Riva P, Kong SH, Saccomandi P, Vita G, Lindner V, Namer IJ, Marescaux J, Diemunsch P, Diana M
Lien Pubmed
Résumé
. Pneumoperitoneum insufflation with warmed and humidified carbon dioxide (WH-CO) can prevent heat loss and increase tissue oxygenation. We evaluated the impact of localized WH-CO insufflation on the anastomotic healing process. . Sixty male Wistar rats were randomized: Group 1 (control, n = 12), Group 2 (cold and dry CO, CD-CO, n = 24), and Group 3 (WH-CO, n = 24). A magnetic compression side-to-side colonic anastomosis was performed under 60-minute local abdominal CO flow insufflation. Animal temperature was recorded. IL-1, IL-6, and CRP levels were assessed before and after insufflation and on postoperative day (POD) 7 and POD 10. Endoscopic follow-up was performed on POD 7 and POD 10. A burst pressure (BP) test of the specimen was performed on POD 10, and histopathological analysis was then performed. Metabolomics of the anastomotic site was determined. . Seven rats (5 CD-CO group, 1 WH-CO group, and 1 control group) died during the survival period. Necropsies revealed intestinal occlusions (n = 2). One additional rat from the CD-CO group was sacrificed on POD 7 due to intestinal perforation. The postoperative course was uneventful in the remaining cases. There was no difference in BP among the groups. Thermal monitoring confirmed that WH-CO insufflation was effective to reduce heat loss. IL-1 levels were statistically and significantly lower on POD 10 in the WH-CO group than the CD-CO group but not lower than the control group. CRP levels, histopathology, and metabolomics did not show any difference between the 3 groups. . WH-CO was effective to preserve core temperature. However, it did not improve anastomotic healing.
Mots clés
CO2 insufflation, anastomotic leak, colonoscopy, colorectal anastomosis, experimental model, magnetic anastomosis, metabolomics profiling
Référence
Surg Innov. 2020 Oct 23;:1553350620967225