Effectiveness of new polymer membranes for intestinal anastomoses

AIM: evaluate the effectiveness of new polymer membranes for prevention of intestinal anastomoses leakage in ex vivo experiment.

MATERIALS AND METHODS: the materials of the present study were new samples (groups No. 1–5) of multilayer polymer membranes (5 groups differing in composition with addition of various antibacterial agents, a contrast agent in different layers) and the membrane, the implanted biopolymer (group No. 6). Study design: experimental single-center comparative prospective with simple blinding. Study terms — 1 month. The end point of the study is the level of intraluminal pressure at the air expiration in the anastomosis zone. The effectiveness studies were conducted by pneumopressing (using an automatic tonometer) a section of the small intestine after applying a singlerow intestinal anastomosis, on which the test samples were placed. The pressure inside the single-row (group 7) and double-row (group 8) anastomoses was also measured without the use of membranes. The study used 7 cm long and 2 cm wide sections of the small intestine taken from ten male cadavers aged between 30 and 45. The samples were collected within 24 hours of death. Each group included 10 samples.

RESULTS: the highest median of pressure value (85 [79.5; 87] mm Hg) was observed in group 8 (double-row anastomosis), with a median difference of 0.5 compared to group 1 (84.5 [83; 85] mm Hg) (using membranes without antibacterial agents) and group 4 (84.5 [83.25; 86] mm Hg) (using membranes with Levofloxacin in the PVP layer and Yogexol in the sodium alginate layer). However, the values of group 8 are statistically significantly higher than the values of groups 6 (62 [60.5; 63] mm Hg) and 7 (63.5 [59.5; 65.75] mm Hg) by 23 (p = 0.002) and 21.5 (p = 0.004) respectively.

CONCLUSION: the study suggests that the mechanical shelter of the intestinal anastomosis with new membrane samples is a fairly effective method for preventing their failure.

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