Poly-ϵ-caprolactone scaffold as staple-line reinforcement of rectal anastomosis: an experimental piglet study

BMC Gastroenterol. 2024 Mar 15;24(1):112. doi: 10.1186/s12876-024-03202-1.

Abstract

Purpose: Rectal anastomoses have a persisting high incidence of anastomotic leakage. This study aimed to assess whether the use of a poly-ϵ-caprolactone (PCL) scaffold as reinforcement of a circular stapled rectal anastomosis could increase tensile strength and improve healing compared to a control in a piglet model.

Method: Twenty weaned female piglets received a stapled rectal anastomosis and were randomised to either reinforcement with PCL scaffold (intervention) or no reinforcement (control). On postoperative day five the anastomosis was subjected to a tensile strength test followed by a histological examination to evaluate the wound healing according to the Verhofstad scoring.

Results: The tensile strength test showed no significant difference between the two groups, but histological evaluation revealed significant impaired wound healing in the intervention group.

Conclusion: The incorporation of a PCL scaffold into a circular stapled rectal anastomosis did not increase anastomotic tensile strength in piglets and indicated an impaired histologically assessed wound healing.

Keywords: Anastomotic leakage; Anastomotic wound healing; Poly-epsilon-caprolactone; Rectal anastomosis; Staple-line; Tensile strength.

MeSH terms

  • Anastomosis, Surgical / adverse effects
  • Anastomotic Leak* / etiology
  • Anastomotic Leak* / prevention & control
  • Animals
  • Caproates*
  • Female
  • Lactones*
  • Rectum / surgery
  • Surgical Stapling*
  • Swine

Substances

  • Caproates
  • caprolactone
  • Lactones