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Pringle maneuver increases the risk of anastomotic leakage after colonic resection in rats

Background - Many centers use the Pringle's maneuver during liver resections. Since this maneuver might impair healing of bowel anastomoses, we evaluated its influence on the healing of colonic anastomosis in rats. - Methods - Male Wistar rats underwent median laparotomy and sigmoid resection w...

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Hauptverfasser: Jansen-Winkeln, Boris (VerfasserIn) , Gaiser, Timo (VerfasserIn) , Hirsch, Daniela (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: May 2018
In: HPB
Year: 2018, Jahrgang: 20, Heft: 5, Pages: 392-397
ISSN:1477-2574
DOI:10.1016/j.hpb.2017.10.010
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.hpb.2017.10.010
Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S1365182X17311231
Volltext
Verfasserangaben:Boris Jansen-Winkeln, Evangelos Tagkalos, Axel Heimann, Timo Gaiser, Daniela Hirsch, Ines Gockel, Jens Mittler, Hauke Lang and Stefan Heinrich

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520 |a Background - Many centers use the Pringle's maneuver during liver resections. Since this maneuver might impair healing of bowel anastomoses, we evaluated its influence on the healing of colonic anastomosis in rats. - Methods - Male Wistar rats underwent median laparotomy and sigmoid resection with end-to-end anastomosis under inhalation anesthesia. Thereafter, rats received a 25 minutes Pringle's maneuver (PM, group 1) or were kept under anesthesia for the same period of time (group 2). The anastomotic bursting pressure (BP) was measured on postoperative days (POD) 3, 6 and 9. Hematoxylin and Eosin (H&E) staining was used for histopathological evaluation of the anastomosis. The Mann-Whitney U and χ2 -tests were used, p<0.05 values were considered significant. - Results - All animals (n=48) lost body weight (BW) until POD3 (95.2% vs. 85.7%, p=0.003), and BW remained lower after PM (106.2% vs. 92.8%, p=0.001). The anastomotic BP was lower in group 1 compared to group 2 on POD 3 (116mmHg vs. 176.28mmHg, p=0.001), POD 6 (182.8mmHg vs. 213mmHg, p=0.029) and POD 9 (197.2mmHg vs. 251.7mmHg, p=0.009), and mortality was higher in group 1 (1 vs. 7, p=0.022). - Conclusions - Pringle's maneuver increases anastomotic complications in rats. Therefore, a Pringle's maneuver should be avoided during simultaneous liver and colorectal surgery. 
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