Journal of Experimental and Clinical SurgeryJournal of Experimental and Clinical Surgery2070-478X2409-143XVoronezh State Medical University160310.18499/2070-478X-2022-15-3-221-227Research ArticleThe prevention of leakage of ileo-colonic anastomosis in an experimental peritonitisVajnerJurij Sergeevich<p>docent, Department of faculty surgery</p>doctorenco@rambler.ruhttps://orcid.org/0000-0002-8742-0424AtamanovKonstantin Viktorovich<p>docent, head of the Department of faculty surgery</p>k_atamanov@hotmail.comhttps://orcid.org/0000-0002-4315-7484BeljakovaTat'jana Sagadatovna<p>assistant, Department of faculty surgery</p>tanya_belyako@mail.ruhttps://orcid.org/0000-0002-4336-0677Novosibirsk state medical University2909202215322122729052022Copyright © 2022, Vajner J.S., Atamanov K.V., Beljakova T.S.2022<p>Introduction. In colon surgery, intestinal anastomotic leaks are the main contributor to postoperative mortality. The incidence of this complication in the formation of small-colonic anastomoses in urgent surgery reaches 12% or more. It is required to develop simple and reliable techniques of intestinal suturing in conditions of peritonitis.<br />The aim of the study was to investigate the morphological events occurring in the small-colonic anastomosis formed using various options under simulated peritonitis.<br />Materials and methods. An experimental study involved 2 groups of Wistar white rats (25 animals - the control group and 25 - the main one). Peritonitis was simulated by dissecting the ileum into circles in 5-6 cm from the ileocecal angle. A day later, a relaparotomy was performed, a section of the intestine with a defect was excised, the distal loop was tied up, a small-colonic anastomosis was formed with a proximal loop: in the end-to-side study group the intervention was performed according to the author's method (RF patent No. 2709253 dated 12/17/2019), in the control group using side-to-side anastomosis. In 6 days, anastomosis was taken from the survived animals for histological examination. Histological examination was carried out at a magnification x400 and x630. Micromorphometry was performed with the count of neutrophils, fibroblasts and measurement of the relative area of blood vessels in the anastomotic suture. Fisher's exact test, Mann-Whitney test were used for statistical data processing, quantitative data were described in the median and interquartile interval format.<br />Results. An original end-to-side anastomosis resulted in a greater number of fibroblasts and blood vessels in the muscular and submucosal layers of the intestinal wall in the suture zone than in the side-to-side anastomosis. The number of anastomotic leaks in the study group was 4 times less than in the control group.<br />Conclusion. The use of the authors end-to-side anastomosis technique improves blood supply and repair of the suture area in a small-colonic anastomosis under 1-day simulated peritonitis; this being accompanied by a decreased incidence of anastomosis failure.</p>peritonitisanastomosisinsolvencyileostomyacute intestinal obstructionперитонитанастомознесостоятельностьилеостомаострая кишечная непроходимость[Cherdancev DV, Pozdnjakov AA, Shpak VV, Rjabkov JuV, Popov AE. Analysis of complications after abdominal operations on the colon. Sovremennye problemy nauki i obrazovanija. 2017; 2: 78. (in Russ.)][Sostojanie onkologicheskoj pomoshhi naseleniju Rossii v 2018 godu. 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