Reduced mucosal perianastomotic capillary density in rat small intestine with chronic radiation damage

Anastomoses in an intestine with chronic radiation damage are prone to leakage, possibly due to a reduced blood supply induced by a reduced capillary bed. In an animal model, the numerical capillary density in the perianastomotic area was investigated in intestine with or without chronic radiation damage. A 2-cm segment of rat ileum received a single dose of 21 Gy. Twenty weeks later, when the chronic radiation-induced changes were established, an anastomosis was constructed in this segment and in a corresponding segment in control rats. In situ perfusion fixation of the intestine was done 4 or 7 days after construction of the anastomosis, sections of the intestine were removed surgically, the specimens were embedded in methacrylate plastic and sectioned at 2.5 microm, and capillaries were counted under a light microscope. The circumferential mucosal capillary density was lower in irradiated than in nonirradiated animals at both 4 and 7 days (P < 0.001 and P = 0.04, respectively). This reduction was greater in the mesenteric quadrant than in the other quadrants around the circumference. These results are indicative of a reduced capillary bed in the vicinity of anastomoses in intestine with chronic radiation damage, which might lead to an impeded blood supply and subsequent leakage.