Comparative morphological characteristics of digestive anastomosis regeneration upon stimulation by autoplasma (experimental study)

The issues of stimulation of regeneration and prevention of intestinal anastomosis failure are still relevant in abdominal surgery. Suture failure of intestinal anastomoses is most often observed in the early postoperative period and can lead to purulent-septic processes in the abdominal cavity, the lethality of which reaches 70 %. The aim of this study was to obtain new data for the results of a comparative macro- and microscopic morphological assessment of the intestinal anastomosis zone in the early and late postoperative period with local injection of platelet-rich autoplasma and without the use of autoplasma. The experiment was performed on 30 sexually mature laboratory rabbits. All animals underwent the imposition of a small-intestinal digestive anastomosis «end to end» (control anastomosis) with a singlelayer intestinal suture at a distance of 15 cm proximal to the ileocecal angle. Having retreated 30 cm proximally from the imposed control anastomosis, enterotomy was performed, followed by injection of platelet-rich autoplasma into the muscular layer of the intestinal wall, with subsequent formation of an intestinal anastomosis. On days 3, 7, 14, relaparotomy, macroscopic assessment of the anastomosis zone, revision of the abdominal cavity, and collection of biopsy material (intestinal wall at the anastomosis site) were performed under general anesthesia. The state of the anastomosis zone, adhesion genesis, and the degree of stenosis of the intestinal anastomosis area were assessed macroscopically. Signs of the regenerative process were examined microscopically. Macroscopic examination showed a significant decrease in the degree of stenosis in the intestinal anastomosis, as well as the absence of signs of an increase in the level of adhesion formation when using autoplasma. Microscopic examination revealed an acceleration of the reparation dynamics, angiogenesis, cellular cooperation, organization of connective tissue, as well as a reduction in the duration of the inflammatory phase in the experimental group (use of platelet autoplasma). The use of intraoperative injection method of autoplasma administration contributes to the acceleration of morphological signs of intestinal anastomosis regeneration, neoangiogenesis and reduction of the period of manifestation of signs of inflammatory response in the zone of intestinal anastomosis, demonstrating the potential of using this method to reduce the incidence of possible complications associated with its failure.

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