Ann Surg Treat Res.  2016 Jun;90(6):315-321. 10.4174/astr.2016.90.6.315.

The effects of scalpel, harmonic scalpel and monopolar electrocautery on the healing of colonic anastomosis after colonic resection

• Karaca G
• Pekcici MR
• Altunkaya
• Fidanci V
• Kilinc A
• Ozer H
• Tekeli A
• Aydinuraz
• Guler O

• KMID: 2164792
• DOI: http://doi.org/10.4174/astr.2016.90.6.315

Abstract

PURPOSE
In our study, the effects of harmonic scalpel, scalpel, and monopolar electrocautery usage on the health and healing of colon anastomosis after resection was investigated.
METHODS
In this study, 120 female albino Wistar rats were divided into 3 groups each containing 40 rats. Group A, resection with scalpel; group B, resection with monopolar electrocautery; group C, resection with harmonic scalpel. The groups were divided into 4 subgroups consisting of 10 rats and analysed in the postoperative 1st, 3rd, 5th, and 7th days. Anastomotic bursting pressures, hydroxyproline levels and histopathological parameters were surrogate parameters for evaluating wound healing.
RESULTS
The tissue hydroxyproline levels did not show any significant difference between the groups and subgroups. The mean bursting pressure of group A on the 5th day was significantly higher than groups B and C (P < 0.001). When the fibroblast and fibrosis scores were evaluated, scores of group C on the 5th day were significantly higher than the other groups, but the results of bursting pressures and biochemical parameters did not support the fibroblast and fibrosis scores. There were not any significant differences between the groups in other histopathologic parameters.
CONCLUSION
The use of monopolar electrocautery needs more attention since the device causes tissue destruction. The obliterating effect of harmonic scalpel on luminal organs is an important problem, especially if an anastomosis is planned. Despite the disadvantages of scalpel, its efficacy on early wound healing is better than the other devices.

Keyword

Electrosurgery; Surgical anastomosis; Colon; Anastomosis healing

MeSH Terms

Anastomosis, Surgical
Animals
Colon*
Electrocoagulation*
Electrosurgery
Female
Fibroblasts
Fibrosis
Humans
Hydroxyproline
Phenobarbital
Rats
Rats, Wistar
Wound Healing
Hydroxyproline
Phenobarbital

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