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01.12.2023 | Original Article

Effects of extensive mobilization and tension anastomosis in anorectal reconstruction (experimental study)

verfasst von: Dmitrii Morozov, Olga Morozova, Lubov Severgina, Olga Mokrushina, Tatyana Marchuk, Ivan Budnik, Hüseyin Özbey, Dmitry Morozov

Erschienen in: Pediatric Surgery International | Ausgabe 1/2023

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Abstract

Purpose

Anorectoplasty and pull-through procedure can be performed with extensive mobilization or tension anastomosis, which can compromise bowel blood perfusion. We aimed to analyze the hypoxia biomarker values and histopathological findings in both conditions to correlate the occurrence of anal stenosis and defecation disorders in experimental models.

Methods

We created anorectal reconstruction models with impaired vascularization of the anorectum (group I) and tension anastomosis (group II) in rats. A third group of animals underwent sham operation (group III) and another as controls (group IV). Hypoxia biomarker values were assessed in all groups. The histopathological changes on the postoperative days 3 and 35, anal stenosis and defecation disorders on day 35 were compared.

Results

Hypoxia biomarker values confirmed postoperative ischemia in groups I–III compared to control. Group I and II rats had a similarly pronounced ischemia with histopathologic changes in the anorectum on the postoperative day 3 and accompanied by severe fibrosis on day 35. Compared to the sham operation, both groups showed defecation disorders with significant anal stenoses.

Conclusion

Extensive rectal mobilization to about the same extent as tension anastomosis has a major impact on postoperative rectal ischemia, resulting in severe fibrotic changes in the anorectum and defecation disorders in the long term.

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Titel: Effects of extensive mobilization and tension anastomosis in anorectal reconstruction (experimental study)
verfasst von: Dmitrii Morozov
Olga Morozova
Lubov Severgina
Olga Mokrushina
Tatyana Marchuk
Ivan Budnik
Hüseyin Özbey
Dmitry Morozov
Publikationsdatum: 01.12.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 1/2023
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-022-05306-9

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Effects of extensive mobilization and tension anastomosis in anorectal reconstruction (experimental study)