Preparation of a pig experimental model of defective colon anastomosis − review
Authors:
J. Rosendorf 1,2; L. Červenková 1; R. Pálek 1,2; S. Šarčevič 1,2; V. Třeška 2; V. Liška 1,2
Authors‘ workplace:
Laboratoř nádorové léčby a regenerace tkáně, Biomedicínské centrum, Lékařská fakulta v Plzni, Univerzita Karlova
1; Chirurgická klinika Lékařské fakulty v Plzni, Univerzita Karlova a Fakultní nemocnice Plzeň
2
Published in:
Rozhl. Chir., 2023, roč. 102, č. 3, s. 105-110.
Category:
Review
doi:
https://doi.org/10.33699/PIS.2023.102.3.105–110
Overview
Anastomotic leak is a serious complication in colorectal surgery. The problem of intestinal anastomosis healing disorders is dealt with by a number of experimental studies, especially in applied research. The design of animal models is diverse and the results of individual studies are difficult to compare. This paper summarizes the main issues of planning animal models of intestinal anastomoses, which are discussed individually. The main part of the text is a description of the defective intestinal anastomosis model of the pig. The anastomosis is constructed in the model with a localized mucosal protrusion. The animals are monitored for 3 weeks postoperatively, the clinical condition and changes in vital values and laboratory parameters are monitored, and CT examinations are performed at defined points. At the end of the observation period, samples are taken, macroscopic findings in the abdominal cavity are evaluated, adhesions are scored, and signs of leakage or passage disorders are assessed. The preparations are evaluated histologically both by standard methods analyzing vascularity, inflammatory infiltration and the proportion of collagen, and by methods developed de novo for the needs of the experiment, such as the analysis of the integrity of the intestinal wall at the site of the mucosal protrusion. We value the experimental model for the possibility of a systematic and detailed analysis of the healing state of the anastomosis in combination with a detailed observation protocol, which produces clinically relevant results.
Keywords:
Animal models – colorectal surgery – anastomotic leakage – experiment – intestinal anastomosis
Sources
1. Chadi SA, Fingerhut A, Berho M, et al. Emerging trends in the etiology, prevention, and treatment of gastrointestinal anastomotic leakage. J Gastrointest Surg. 2016 Dec;20(12):2035−2051. doi:10.1007/s11605-016-3255-3.
2. Foppa C, Ng SC, Montorsi M, et al. Anastomotic leak in colorectal cancer patients: New insights and perspectives. Eur J Surg Oncol. 2020 Jun;46(6):943−954. doi:10.1016/j.ejso.2020.02.027.
3. Bhama AR, Maykel JA. Diagnosis and management of chronic anastomotic leak. Clin Colon Rectal Surg. 2021 Nov 23;34(6):406−411. doi:10. 1055/s-0041- 1732322.
4. Kelm M, Anger F. Mucosa and microbiota − the role of intrinsic parameters on intestinal wound healing. Front Surg. 2022 Jul 22;9:905049. doi:10.3389/ fsurg.2022.905049.
5. Gruber FP, Hartung T. Alternatives to animal experimentation in basic research. ALTEX 2004;21 Suppl 1:3−31.
6. Rosendorf J, Horakova J, Klicova M, et al. Experimental fortification of intestinal anastomoses with nanofibrous materials in a large animal model. Sci Rep. 2020 Jan 24;10(1):1134. doi:10.1038/s41598-020- 58113-4.
7. Rosendorf J, Klicova M, Cervenkova L, et al. Double-layered nanofibrous patch for prevention of anastomotic leakage and peritoneal adhesions, experimental study. In Vivo 2021 Mar−Apr;35(2):731−741. doi:10.21873/invivo. 12314.
8. Rosendorf J, Klicova M, Cervenkova L, et al. Reinforcement of colonic anastomosis with improved ultrafine nanofibrous patch: Experiment on pig. Biomedicines 2021 Jan 21;9(2):102. doi:10.3390/biomedicines9020102.
9. Burke JR, Helliwell J, Wong J, et al. The use of mesenchymal stem cells in animal models for gastrointestinal anastomotic leak: A systematic review. Colorectal Dis. 2021 Dec;23(12):3123−3140. doi:10.1111/codi.15864.
10. Wang M, Donovan SM. Human microbiota- associated swine: current progress and future opportunities. ILAR J. 2015;56(1):63−73. doi:10.1093/ilar/ ilv006.
11. Gonzalez LM, Moeser AJ, Blikslager AT. Porcine models of digestive disease: the future of large animal translational research. Transl Res. 2015 Jul;166(1):12−27. doi:10.1016/j.trsl.2015.01.004.
12. Seifert WF, Biert J, Wobbes T, et al. Late effects of intraoperative radiation therapy in anastomotic rat colon. Int J Radiat Oncol Biol Phys. 1998 Oct 1;42(3):623−629. doi:10.1016/s0360-3016(98)00259-4.
13. Jahnson S, Holtz A, Gerdin B. Anastomotic blood-flow reduction in rat small intestine with chronic radiation damage. Digestion 1998;59(2):134−141. doi:10.1159/000007478.
14. Van de Putte D, Demarquay C, Van Daele E, et al. Adipose-derived mesenchymal stromal cells improve the healing of colonic anastomoses following high dose of irradiation through anti-inflammatory and angiogenic processes. Cell Transplant. 2017 Dec;26(12):1919−1930. doi:10.1177/0963689717721515.
15. Miltschitzky JRE, Clees Z, Weber MC, et al. Intestinal anastomotic healing models during experimental colitis. Int J Colorectal Dis. 2021 Oct;36(10):2247−2259. doi:10.1007/s00384-021-04014-5.
16. Bachmann R, Van Hul M, Leonard D, et al. The colonoscopic leakage model: a new model to study the intestinal wound healing at molecular level. Gut 2020 Dec;69(12):2071−2073. doi:10.1136/gutjnl- 2020-321234.
17. Neumann PA, Twardy V, Becker F, et al. Assessment of MMP-2/-9 expression by fluorescence endoscopy for evaluation of anastomotic healing in a murine model of anastomotic leakage. PLoS One. 2018 Mar 22;13(3):e0194249. doi:10.1371/journal. pone.0194249.
18. Wenger FA, Szucsik E, Hoinoiu BF, et al. A new anastomotic leakage model in circular double stapled colorectal anastomosis after low anterior rectum resection in pigs. J Invest Surg. 2013 Dec;26(6):364−372. doi:10.3109/089419 39.2013.818174.
19. Fan C, Ma J, Zhang HK, et al. Sutureless intestinal anastomosis with a novel device of magnetic compression anastomosis. Chin Med Sci J. 2011 Sep;26(3):182−189. doi:10.1016/s1001-9294(11)60046-1.
20. Ikeuchi D, Onodera H, Aung T, et al. Correlation of tensile strength with bursting pressure in the evaluation of intestinal anastomosis. Dig Surg. 1999;16(6): 478−485. doi:10.1159/000018773.
21. Ma F, Ma J, Ma S, et al. A novel magnetic compression technique for small intestinal end-to-side anastomosis in rats. J Pediatr Surg. 2019 Apr;54(4):744−749. doi:10.1016/j.jpedsurg.2018.07.011.
22. Pommergaard HC, Achiam MP, Rosenberg J. Colon anastomotic leakage: improving the mouse model. Surg Today 2014 May;44(5):933−939. doi:10.1007/ s00595-013-0632-3. Epub 2013 Jun 9. PMID: 23748879.
23. Kalvach J, Ryska O, Martinek J, et al. Randomized experimental study of two novel techniques for transanal repair of dehiscent low rectal anastomosis. Surg Endosc. 2022 Jun;36(6):4050−4056. doi:10.1007/s00464-021-08726-1.
24. Taşdöven İ, Emre AU, Gültekin FA, et al. Effects of ozone preconditioning on recovery of rat colon anastomosis after preoperative radiotherapy. Adv Clin Exp Med. 2019 Dec;28(12):1683−1689. doi:10.17219/acem/110329.
25. Fontoura-Andrade JL, Pinto LM, Carneiro FP, Sousa JB. Effect of preconditioning and postoperative hyperbaric oxygen therapy on colonic anastomosis healing with and without ischemia in rats. Acta Cir Bras. 2020 Jun 22;35(5):e202000503. doi:10.1590/s0102- 865020200050000003. PMID: 32578671; PMCID: PMC7310584.
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Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2023 Issue 3
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