• A Karliczek, C J Zeebregts, D A Benaron, R P Coppes, T Wiggers, and G M van Dam.
• Department of Surgery, University Medical Center Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands.
• Int J Colorectal Dis. 2008 Nov 1; 23 (11): 1115-24.

IntroductionThere are conflicting studies on the influence of fractionated preoperative 5 days of 5 Gy irradiation on tissue oxygenation and subsequent colonic anastomotic strength. To elucidate the effect of preoperative irradiation on anastomotic strength, an isolated colon loop model was developed.MethodsMale Wistar rats (n = 164) were randomly divided into three groups. One group remained untreated (control). In the other two groups, a loop of descending colon was exteriorized to create a hernia of the abdominal wall. After 4 weeks' recovery, this loop was locally irradiated with 5 x 5 Gy of gamma-rays or sham irradiated. One week after (sham-) irradiation, an anastomosis was performed in all groups. Tissue oxygenation (StO2) was determined with visible light spectroscopy. The animals were sacrificed 3 or 7 days after the operation and the anastomosis was tested for bursting pressure and breaking strength.ResultsIrradiated rats showed significantly more weight loss (90% SD 4.3 of initial body weight vs. 96% SD 2.8, p < or = 0.05) and enteritis (18% vs. 5%, p = 0.013) compared to sham and control animals. StO2 was not influenced by irradiation and was not predictive for anastomotic strength. The control group showed significantly lower bursting pressure and breaking strength compared to (sham-) irradiated animals.ConclusionWe developed a new isolated loop model for intermittent irradiation of the colon. Preoperative irradiation of the distal part of a colon anastomosis was successfully administered with acceptable side effects and did not cause reduced tissue oxygenation nor clinical signs of anastomotic weakening, nor objective reduction in bursting pressure and breaking strength.

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