Alaa A Al-Bakry, Hameed A Al-Timmemi
The modified continuous Gambee technique was associated with progressive reduction of radiographic stenosis and acceptable macroscopic healing findings among surviving rabbits. However, fatal anastomotic leakage occurred, and the absence of a comparative group limits conclusions regarding the contribution of this technique to the observed healing outcomes.
UNLABELLED: Colonic anastomosis is a critical gastrointestinal procedure, with postoperative leakage, adhesions, and stenosis remaining major concerns.
OBJECTIVE: To evaluate the healing progression of end-to-end colonic anastomosis using the modified continuous Gambee technique in rabbits through clinical, macroscopic, and radiographic assessment at different intervals.
METHODS: Fifteen adult male rabbits were randomly assigned using a simple random drawing method to evaluation intervals of 7, 14, and 28 days (n = 5 each). After resection of a 2 cm colonic segment, anastomosis was performed using a modified continuous Gambee pattern with 5-0 polydioxanone suture. Three rabbits developed fatal anastomotic leakage before scheduled evaluation and were replaced according to the approved protocol. Evaluations included clinical monitoring, weight changes, leakage testing, adhesion scoring, and radiographic stenosis measurement.
RESULTS: Fatal leakage occurred in 3/18 rabbits (16.7%), with necropsy confirming anastomotic dehiscence and local contamination. No macroscopic leakage was detected in surviving rabbits. Adhesion scores showed no significant differences among intervals (P > 0.05). Radiographic stenosis significantly decreased from Day 7 (49.20 ± 2.92%) to Day 14 (22.38 ± 3.17%) and Day 28 (15.94 ± 1.26%) (P < 0.001). Surviving animals showed return of normal activity and feeding with postoperative weight reduction.
CONCLUSION: The modified continuous Gambee technique was associated with progressive reduction of radiographic stenosis and acceptable macroscopic healing findings among surviving rabbits. However, fatal anastomotic leakage occurred, and the absence of a comparative group limits conclusions regarding the contribution of this technique to the observed healing outcomes.