Journals / Selçuk Tıp Dergisi / 2000 / Cilt: 16 - Sayı: 4
Mekanik ileus sonrası ince barsak anastomozlarında fibrin glue'nun etkinliği
- Journal
- Selçuk Tıp Dergisi
- Pages
- 271–277
- DOI
- —
Abstract
Aim: In this study, the mechanichal resistance of the different kind of anastomoses made traditional suture materials and fibrin glue, and related cell infiltration in small intestine anastomoses performed after mechanical obstuction investigated. Material and Method: This study was performed on 30 rats which were divided into two groups (15 Each) After 24 hours of the mechanical obstructions was made and after 24 hours a traditional suture material anastomoses was performed in one group while fibrin glue anastomose was performed to other group. The bursting pressure of the anastomoses and perianastomose cell infiltration were invastigated in both groups three days later. Results: We observed that, the usage of fibrin glue did not affected the mortality while was found to be more reliable considering leake from the anastomoses . The bursting pressure of the anastomoses made by suture material was 25.7 mmHg which was found to be 23.7 mmHg when fibrin glue was used. However, there was no statistically significant difference between those two results. Also the cell infiltration was observed to be more when fibrin glue was used compared to other group, but the differce was not statistically significant. In conclusion, the present study shows that the usage of fibrin glue in accurate concentration and amount might be an effective method in preventing leakage after anastomoses.
Özet
Giris ve Amaç: Bu çalismada ratlarda olusturulan deneysel mekanik obstürüksiyon sonrasi yapilan ince barsak anastomozlarinda, geleneksel dikis malzemeleri ile fibrin glue kullanilarak yapilan anastomozlarin mekanik dirençleri ve reaksiyonel hücresel infiltrasyonlari karsilastirildi. Gereç ve Yöntem: Bu çalismada onbeserli iki gruba ayrilmis otuz rat kullanildi. Ilk önce mekanik obstürüksiyon yapildi. Yirmidört saat sonra birinci grup da geleneksel sütür metaryali ile diger grup da ise fibrin glue ile anastomoz yapildi. Anastomozlardaki patlama basinci ve anastomoz çevresindeki hücresel infitrasyon degerleri arastirildi. Bulgular : Fibrin gluenun mortaliteyi etkilemedigi ayrica anastomoz kaçagi yönünden fibrin gluenun daha güvenilir oldugu bulundu. Çalismamizda fibrin kullanilan grupta makroskopik anastomoz kaçagi görülmedi. Sütür materyali ile yapilan anastomozlardan 5'inde makroskopik anastomoz kaçagi izlendi. Buna ragmen sütür materyali ile yapilan anastomozlarda patlama basinçlari ortalama olarak 25,7 mmHg olarak bulunurken fibrin glue ile yapilan anastomozlarda patlama basinçlarinin ortalamasi 23,7 mmHg olarak bulundu. Her iki deger arasindaki farkin istatistiksel olarak anlam ifade etmedigi görüldü. Hücresel infiltrasyonun fibrin glue ile daha fazla oldugu fakat yine de fibrin gluenun istenmeyen bu etkisinin istatistiksel olarak anlam ifade etmedigi bulundu. Sonuç : Sonuç olarak fibrin glue uygun konsantrasyon ve miktarda kullanildiginda ince barsak mekanik tikanmalari sonrasinda yapilan anastomozlardan olan sizintilarin giderilmesinde etkili bir yöntem olabilir.