Objective:

The most important complication following colorectal surgery is the anastomotic leakage. The aim of this study was to investigate the protective effect of thermal preconditioning and preoperative warming in the short and long term manner on anastomotic healing as well as to compare these two procedures to find out which is superior.

Material and Methods:

Forty-eight Wistar rats were randomly assigned into six groups, each consisting of 8 rats. The groups were formed as short (3 days) and long (7 days) term anastomoses (control), short and long term thermal preconditioning, and short and long term preoperative warming groups. Anastomotic healing was assessed on postoperative day 4 and 7 by determining anastomotic bursting pressure, tissue hydroxyproline content and histopathological examination.

Results:

The hydroxyproline levels were significantly higher in long term than those of short term (p=0.01). While preoperative warming had no effect on the hydroxyproline levels in short term, they were significantly higher in thermal preconditioning (TP) group than those of preoperative warming (PW) (p=0.01). In addition, the long term bursting pressures were found to be increased in all groups (p=0.01, for three groups) without any significant differences between groups both in short and long terms. Neither TP nor PW did affect the fibrotic index in STA and LTA groups.

Conclusion:

Colonic anastomoses performed with thermal preconditioning technique, increase the collagen synthesis on the anastomosis line in the early period of healing, and it is obvious that this technique could contribute to the anastomosis stability. Although the other parameters do not support our opinion, we believe further experiments about optimum heat and time would be a guide.

Keywords: Anastomotic healing thermal preconditioning preoperative warming