Effects of Intraperitoneal PEG-4000 Administration on Small Bowel Anastomosis: Experimental Study

Peritoneal adhesion, which is seen after abdominal operations, is still an important problem. Studies showed that PEG-4000 could prevent abdominal adhesions, but the effects of PEG-4000 on anastomotic healing are unclear. To research these effects an experimental study was performed. Sixty-four rabbits were divided into 4 groups, each of containing 16 rabbits. In groups 1-3, 10 cm proximal to ileocecal valve the ileum was transected and anastomosis was performed. In group 4, only laparotomy was performed. Animals received 20 ml 40% PEG-4000 in group 1, 20 ml 20% PEG-4000 in group 2, 20 ml saline solution in group 3 intraperitoneally. Each group was divided into two subgroups, each containing 8 rabbits. On the 2nd postoperative day in subgroups 1a, 2a, 3a after laraparotomy, 5cm proximal and distal to previous anastomosis, ileal resection and ileoileal anastomosis, and in group 4a 10cm proximal to ileocecal valve a-10cm-ileal segment was resected and anastomosis was performed. The same procedures were performed in subgroups 1b, 2b, 3b, and 4b on the 7th postoperative day. Tissue hydroxyproline levels and anastomotic brust pressures were measured in resected intestinal segments, and histopathologic examination was performed. Wound healing scores and hydroxyproline levels were significantly higher in group 4 compared to other groups. 40% PEG-4000 has more negative effects on anastomotic healing on the 2nd and 7th postoperative days compared to saline solution. There were no significant differences between 40% and 20% PEG-4000 solutions on the 2nd postoperative day, but some significant ones on the 7th postoperative day. There were no significant differences between 20% PEG- 4000 and saline solutions on the 2nd and 7th postoperative days. Further studies are needed to prove the clinical use of PEG-4000