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2001, Number 2

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Cir Gen 2001; 23 (2)

Effects of malnutrition on the colonic anastomosis in the rat

Domínguez JGL, Athié AAJ, Mijares GJM, Cárdenas LE, Pérez RE

Language: Spanish
References: 16
Page: 81-86
PDF size: 48.07 Kb.


ABSTRACT

Objective: To determine frequency of dehiscences of the colonic anastomosis in the rat, an experimental model.
Setting: Third level health care hospital.
Design: Experimental, prospective, comparative study. Material and methods: Thirty-eight Wistar rats, approximately 1 year of age, were used. Rats were assigned to two groups. Group A (undernourished) and Group B (well-nourished). Group A was subjected to a hypocaloric diet (18 kcal/day) for one week to induce a 20% weight loss. Group B received a 72 kcal/day diet for the same period of time. In both groups, we quantified: weight, albumin, and total lymphocytes. All rats were operated. Under general anesthesia, 1 cm of the left colon was resected, placing a ligature on the marginal artery and performing anastomosis in a single plane using 6-0 polypropylene with interrupted plain stitches.
Statistical analysis: Descriptive statistics was used for independent variables, Chi square and exact Fisher’s tests for nominal variables, and Student’s t test for quantitative variables. Null hypothesis was rejected at an alpha value minor than 0.05, at a significance level of 90% (We used Word 2000, EPIINFO, Version 5).
Results: Nutritional parameters: In group A, a weight loss of 25% was observed (initial weight 466 g, final weight 347 g); p › 0.05. Albumin decreased from 1.61 (SD ± 0.16) to 1.17 (SD ± 0.20); p › 0.05. Lymphocytes decreased from 11,119 (SD ± 3,263) to 3,235 (SD ± 2,130) with p › 0.05. In group B, the initial weight was 505 g (SD ± 66) and the final weight was 506 g (SD ± 62); initial albumin increased from 1.65 (SD ± 0.27) to 3.58 (SD ± 0.21), and the lymphocytes count increased from 9,261 (SD ± 4,406) to 10,065 (SD ± 4,468). Surgical findings: In group A, from 19 rats, 9 presented dehiscence of the anastomosis, 9 died, and 2 presented pericolonic abscesses, only in eight was the anastomosis uneventful. In group B, only 5 rats developed adherences around the anastomosis, no deaths occurred.
Conclusion: The nutritional state affects colonic cicatrization, induces immunodepression, fostering development of abscesses.


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