Effects Of Early Postoperative Feeding On Gastrointestinal Anastomotic Fistula And Healing Time In Rabbits

Objectives：To determine whether early postoperative feeding could attenuatethe inhibitory effects of intestinal anastomosis in rabbits.Methods：48rabbits were randomly divided into experimental group andcontrol group,then both of them underwent gastrointestinal anastomosis,the rabbits of experimental group began to be fed liquid diet after*postoperative24h,and the rabbits of control group were fed nothingafter operation and supplied by total parenteral nutrition. Four rabbits ofeach group were selected to be done exploratory laparotomy on the3rd,5th,7th,10th and15th day after operation,and the healing rate ofthe anastomosis, the anastomotic bursting pressure, the anastomoticbreaking strength, the hychoxyproline content of anastomosis wereobserved respectively.Results：The healing of the anastomosis of control group:91.6%(22/24), thehealing of the anastomosis of experimental group:95.8%(23/24).Theanastomotic bursting pressure: Both of the groups decreased remarkably on the72ed hour after operation,which was the lowest point. Both ofthem recreased remarkably on the5th day after operation, but theanastomic bursting pressure of experimental group was a little lowerthan that of the control group, and which of control group reached thepeak on the7th day after operation. On the10th day after operation,theanastomic bursting pressure of control group was a little lower thanthat on the7th day after operation, but which of the experimental groupreached the peak. There was no statistical differences between each pairof point of two groups(p>0.05).The anastomotic breaking strength: therewas no remarkable differences between two groups at the72ed hourafter operation, both of them reached the lowest point, however which oftwo group recreased remarkably on the10th day after operation, andreached the peak. But there was no statistical differences between eachpair of point of two groups(p>0.05). The hychoxyproline content ofanastomosis: the number of experimental group was a little lower thanthat of control group at the72ted hour after operation,which of both ofthem reached peak on the7th day after operation. But there was nostatistical differences between each pair of point of two groups (p>0.05).HE staining: on the5th day microscopic tissue sections were observed,showing that the two groups of animals anastomotic tissue were floodedwith neutrophils, mucosal tissue necrosis obvious, but fibroblasts andnew blood vessels are less present, on the5th day two groups of animals anastomotic tissue decreased neutrophils, lymphocytes and monocytesslowly increased, the degree of mucosal tissue necrosis and sheddingsignificantly higher than before to reduce and visible fibroblasts andcapillary the formation of granulation tissue gradually dominated, on topof the wound vertical growth of new blood vessels is also the first10thday after surgery, two slices of neutrophils, monocytes, lymphocyteshave been restored to normal levels, and in order to become visiblefibroblasts and collagen fibers oriented scar formation. On the3th,5th,7th,10th days, there was no significant difference between thetwo sections in the light microscope. Gastrointestinal anastomosis arearatio of collagen fibers: changes in the area of collagen is very similar inboth groups at each time point and the process of change in HE staining,but each time point anastomotic collagen fiber area ratio comparing thetwo groups was not statistically significant (P>0.05).Conclusions:Early postoperative feeding does not cause the increase ofanasmotic healing time and the rate of gastrointestinal anastomotic leak.