Intestinal anastomotic healing models during experimental colitis

• Published in: International journal of colorectal disease Vol. 36; no. 10; pp. 2247 - 2259
• Main Authors: Miltschitzky, J. R. E., Clees, Z., Weber, M.-C., Vieregge, V., Walter, R. L., Friess, H., Reischl, S., Neumann, P.-A.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2021; Springer; Springer Nature B.V
• Subjects: Analysis; Anastomosis; Anastomotic leak; Animal experimentation; Animal models; Colitis; Dehiscence; Endoscopy; Gastroenterology; Hepatology; Inflammatory bowel disease; Inflammatory bowel diseases; Inflammatory diseases; Internal Medicine; Intestine; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Original; Original Article; Proctology; Recovery of function; Risk factors; Surgery; Dextran sodium sulfate; Anastomotic leakage; Insufficient healing
• ISSN: 0179-1958; 1432-1262
• DOI: 10.1007/s00384-021-04014-5

Background Anastomotic leakage represents a major complication following resections in colorectal surgery. Among others, intestinal inflammation such as in inflammatory bowel disease is a significant risk factor for disturbed anastomotic healing. Despite technical advancements and several decades of focused research, the underlying mechanisms remain incompletely understood. Animal experiments will remain the backbone of this research in the near future. Here, instructions on a standardized and reproducible murine model of preoperative colitis and colorectal anastomosis formation are provided to amplify research on anastomotic healing during inflammatory disease. Methods We demonstrate the combination of experimental colitis and colorectal anastomosis formation in a mouse model. The model allows for monitoring of anastomotic healing during inflammatory disease through functional outcomes, clinical scores, and endoscopy and histopathological examination, as well as molecular analysis. Discussion Postoperative weight loss is used as a parameter to monitor general recovery. Functional stability can be measured by recording bursting pressure and location. Anastomotic healing can be evaluated macroscopically from the luminal side by endoscopic scoring and from the extraluminal side by assessing adhesion and abscess formation or presence of dehiscence. Histologic examination allows for detailed evaluation of the healing process. Conclusion The murine model presented in this paper combines adjustable levels of experimental colitis with a standardized method for colorectal anastomosis formation. Extensive options for sample analysis and evaluation of clinical outcomes allow for detailed research of the mechanisms behind defective anastomotic healing.