The effect of extracoporeal schock waves on intestinal anastomosis

To investigate the effect of extracorporeal shock waves on the healing of intestinal anastomosis.

Thirty Wistar rats were randomly divided into three groups of ten each comprising of Group I (only laparotomy), Group II (right colon segment resection and end to end anastomosis) and Group III (right colon segment resection and end to end anastomosis). Group III animals a total of 1200 impulse 0.12 mj/mm 2 shock waves on the post-operative 3rd , 5th and 7th days in three session each of which included 400 impulse with 14KV. On the 10th post operative day, the rats were sacrificed and postmortem examination was done. The explosion pressures were measured using a sphygmomanometer specially designed for this purpose. In the study groups 4 cm intestine segments which include anastomose line was taken out. The segments which include anastomosis of the study group and the control group pieces were histopathologically examined. The fibroblast, collagen, angiogenesis and inflammatory cells were studied.

The mean anastomoses explosion pressure for group III was 272 ± 7.895 and the average anastomose explosion pressure was 220 ± 6.831. The difference between the pressure means was significant (P < 0.05). Histological fibroblast/collagen ratio were 14.50 ± 5.66, 274 ± 66.21 and 416 ± 52.44 for Group I, Group II and Group III, respectively. The vein amount was 5.80 ±3.19, 51.20±10.76 and 75.10±13.80, respectively. In Group III, fibroblast/collagen and vein ratio was significantly higher compared to Group I and II (3.19, 51.20 ± 10.76 and 75.10 ± 13.80, respectively. In Group III, fibroblast/collagen and vein ratio was significantly higher compared to Group I and II (P < 0.05).

From the results of our study, extracorporeal shock waves treatment (ESWT) increase the intestinal tensile strength and may be useful to enhance the mechanical strength of anastomosis of the colon during healing.