Colonic anastomotic healing and oxygen tension

Abstract

Abstract Using a Clark oxygen electrode and a 133Xe clearance technique, tissue oxygen tension (To2) and blood flow have been determined in the small and large bowel of a rabbit experimental model. The predictive value of perianastomotic To2 in colonic anastomoses was determined, healing being assessed by leakage rate, tensile strength and hydroxyproline content. The effect of suture technique on colonic perianastomotic To2 has also been studied. Colonic and small intestinal To2 correlated with blood flow (r = 0·93). Basal colonic blood flow and oxygen tension were significantly lower than in the small intestine (P<0·01). Interrupted and continuous suture techniques decreased colonic perianastomotic To2, although mean To2 in the continuous group was significantly lower than in the interrupted group (P<0·01). The leakage rate was 10 per cent (1/10) for anastomoses constructed with a perianastomotic To2 above 55 mmHg compared with 100 per cent (10/10) if less than 25 mmHg (P<0·001). Perianastomotic To2 correlated with breaking energy (P<0·001), breaking strength (P<0·01) and hydroxyproline content (P<0·05).