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

https://www.ncbi.nlm.nih.gov/pubmed/33095686

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.