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Postoperative changes in collagen synthesis in intestinal anastomoses of the rat: differences between small and large bowel.
  1. M F Martens,
  2. T Hendriks
  1. Department of General Surgery, St Radboud University Hospital, Nijmegen, The Netherlands.


    Collagen synthesis is an essential feature of anastomotic healing in the intestine. Postoperative collagen synthesis, measured in vitro in intestinal anastomoses was studied from three hours to 28 days after operation. For this purpose, an ileal and a colonic anastomosis were constructed within the same animal and the results in both intestinal segments were compared. In the ileum, collagen synthesis was significantly increased, with respect to unoperated controls, three hours after operation. It remained raised during the period of study, with a maximal 10-fold stimulation four days after operation, and had nearly returned to the preoperative level after four weeks. The general pattern was the same in the colon, although quantitatively different: the increase in synthetic activity was delayed in comparison with the ileum. Maximal stimulation was approximately six-fold. In addition, we calculated the ratio for each rat between anastomotic collagen synthesis and the average value found in non-operated control animals. Postoperative stimulation in the ileum was higher than in the colon in almost every animal examined. The results show that the ileum responds more quickly and strongly to wounding than the colon, at least as far as the production of new collagen is concerned. Possibly, this phenomenon contributes to the lower failure rate apparent for anastomoses in the small bowel.

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