Histological characteristics of collagen denaturation and injuries in bipolar radiofrequency-induced colonic anastomoses

•Bipolar radiofrequency-induced thermo-fusion can achieve colonic anastomoses.•Higher compressive pressure results in more severe collagen unfolding.•Excessive compressive pressure reduces collagen crosslinking in fused colon.•The combination of operation time and power affects histological injury o...

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Published inPathology, research and practice Vol. 211; no. 3; pp. 214 - 218
Main Authors Zhao, Lingxi, Zhuo, Changhua, Song, Chengli, Li, Xinxiang, Zhou, Yu, Shi, Debing
Format Journal Article
LanguageEnglish
Published Germany Elsevier GmbH 01.03.2015
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Summary:•Bipolar radiofrequency-induced thermo-fusion can achieve colonic anastomoses.•Higher compressive pressure results in more severe collagen unfolding.•Excessive compressive pressure reduces collagen crosslinking in fused colon.•The combination of operation time and power affects histological injury on muscles. Bipolar radiofrequency-induced thermo-fusion has been explored as an advanced surgical method for intestinal anastomoses; however, the histological characteristics of collagen denaturation and injuries arising from this process remain unclear. The aim of this study was to investigate the microcosmic changes and tissue damage of fusion regions with various parameters of injury. Ex vivo colons of pigs were fused serosa-serosa on two carrier rings, which were installed on a homemade anastomotic device. Five levels of compressive pressure from 171 to 313kPa were applied for 5s to fuse the colons under radiofrequency power of 160W, and then the collagen denaturation of the fused region was examined by transmission electron microscopy. Light microscopy was utilized to observe histological slices that were stained with picrosirius red in order to visualize the tissue injuries under two levels of radiofrequency power (120 vs. 140W) and operation time (5 vs. 10s). Transmission electron micrographs showed that increased compressive pressure led to thicker denatured collagen fibrils and wider gaps between each collagen fibril. Serosa adhesion regions appeared abundant in collagen. No histological differences were observed when 120W of power was applied for 5 and 10s. Significant muscle cracking occurred when colons were fused using 140W for 5s. When the operation time was extended to 10s, 140W led to tight fusion and less splitting on muscles. These results suggest that higher compressive pressure results in more severe collagen unfolding and also reduces collagen crosslinking in fused colons. Improved radiofrequency power along with operation time could avoid tissue injury upon radiofrequency-induced colonic anastomoses.
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ISSN:0344-0338
1618-0631
DOI:10.1016/j.prp.2014.10.010