The effectiveness of a fecal diverting device for prevention of septic complications in a dog model of ischemic bowel anastomosis

Sung Il Kang, So Hyun Kim, Sang Hun Jung, Jae Hwang Kim
Asian Journal of Surgery 2019 April 11

OBJECTIVE: A type of bypass tube for a fecal diversion device (FDD) was created to protect colorectal anastomosis. We evaluated the effectiveness of the FDD in an animal study.

METHODS: The study was performed in an experimental animal laboratory of a tertiary referral center hospital. Thirty mongrel dogs were randomized to the FDD or control group (n = 15, each). An ischemic anastomosis model was used to readily produce anastomotic leakage (AL) in both groups. The FDD was fixed intraluminally at 10 cm above the anastomotic site in the FDD group. No protective methods were used in the control group. The postoperative observation period was 3 weeks.

RESULTS: The 3 week-survival rates were higher in the FDD group compare with the control group (80%, 12/15 vs. 40%, 6/15; log-rank, P = 0.024). The incidence of AL causing generalized peritonitis was lower in the FDD group than in the control group (20.0%, 3/15 vs. 60.0%, 9/15; P = 0.025) despite the overall incidence of complications being similar in the both groups (53.3%, 8/15 vs. 66.7%, 10/15; P = 0.456). Colonic wall erosions in the FDD fixing area were seen in two subjects (13.3%) in the FDD group. However, the two subjects survived to the end of the experimental period. In the FDD group, five subjects (33.3%, 5/15) did not retain their FDD, and three among them died from generalized peritonitis.

CONCLUSION: This study shows the effectiveness of the FDD at preventing septic complications in a dog model of ischemic bowel anastomosis.

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