Impaired Blood Supply in the Colonic Anastomosis in Mice Compromises Healing

Colon anastomotic leakage has a multifactorial etiology and ischemia is considered one of the most important single factors. However, no existing animal models have established a direct link between ischemia and anastomotic leakage. The aim of this study was to establish a model of colon anastomotic leakage as a result of tissue ischemia. In colon anastomoses of 53 C57BL/6 mice, varying degrees of ischemia were induced. Supplying vessels were divided with bipolar coagulation in order to reduce anastomotic breaking strength and create clinical anastomotic leakage. Breaking strength of all the ischemic anastomoses were significantly lower compared with controls. Increasing ischemia resulted in higher rates of large bowel obstruction without creating anastomotic leakage. Healing was compromised as a result of impaired blood supply. However, clinical leakage was absent. Pure ischemia in otherwise healthy experimental animals may be too simple of an approach to create clinical leakage.