Effects of tension on local blood flow in experimental intestinal anastomoses. 1986

J Shikata, and T Shida

In intestinal anastomoses, local blood flow is one of the most important factors contributing to the success of the healing process. While submucosal local blood flow is maintained better in the colon than in the small intestine, the incidence of anastomotic leakage is higher in the former than in the latter. To resolve this conflict, we have examined differences in the reactivity of the intestinal segments toward the application of tension. Anastomosis was performed with a stapler on the jejunum, ileum, and colon of experimental dogs. The anastomotic sites were subjected to tensile loads applied in incremental steps to measure and compare local blood flow, measured by the hydrogen clearance method, in the submucosal layers of the anastomoses in these intestinal segments. The results of these comparative evaluations indicate that, at a tensile stress level of more than 4 g/mm2, local blood flow in the colon is significantly smaller than that in the jejunum and ileum. These findings were corroborated by microangiographical observations carried out during stress application. The microangiographical data suggest that the rate of filling of the contrast medium is lower with colonic anastomosis than with jejunal and ileal anastomoses. In addition, the intraluminal pressure of the colon was higher than that of the small intestine during the induced peristalsis. The different sensitivity of the local microcirculation systems of the intestinal segments to tension may thus be considered one of the factors accounting for the higher incidence of clinical suture failure in colonic than in small intestinal anastomoses.

UI MeSH Term Description Entries
D007421 Intestine, Small The portion of the GASTROINTESTINAL TRACT between the PYLORUS of the STOMACH and the ILEOCECAL VALVE of the LARGE INTESTINE. It is divisible into three portions: the DUODENUM, the JEJUNUM, and the ILEUM. Small Intestine,Intestines, Small,Small Intestines
D008297 Male Males
D008833 Microcirculation The circulation of the BLOOD through the MICROVASCULAR NETWORK. Microvascular Blood Flow,Microvascular Circulation,Blood Flow, Microvascular,Circulation, Microvascular,Flow, Microvascular Blood,Microvascular Blood Flows,Microvascular Circulations
D010528 Peristalsis A movement, caused by sequential muscle contraction, that pushes the contents of the intestines or other tubular organs in one direction. Peristalses
D011312 Pressure A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Pressures
D012039 Regional Blood Flow The flow of BLOOD through or around an organ or region of the body. Blood Flow, Regional,Blood Flows, Regional,Flow, Regional Blood,Flows, Regional Blood,Regional Blood Flows
D003106 Colon The segment of LARGE INTESTINE between the CECUM and the RECTUM. It includes the ASCENDING COLON; the TRANSVERSE COLON; the DESCENDING COLON; and the SIGMOID COLON. Appendix Epiploica,Taenia Coli,Omental Appendices,Omental Appendix,Appendices, Omental,Appendix, Omental
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D005260 Female Females
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia

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