The purpose of this experimental study was to investigate whether the delayed, postoperative, intraperitoneal administration of 5-fluorouracil plus folinic acid had adverse effects on wound healing, as did their early administration. Seventy male Wistar rats underwent colonic resection followed by anastomosis of the colon. The animals were randomized into four groups. The rats in control group 1 received a 0.9% NaCl solution intraperitoneally and those in group 2 received 5-fluorouracil (20 mg/kg) plus folinic acid (2 mg/kg) immediately after surgery and for the next 3 days. The rats in control group 3 and those in group 4 received intraperitoneally a 0.9% NaCl solution or 5-fluorouracil plus folinic acid, respectively, from postoperative day 4 to day 7. The rats were sacrificed on the 8th postoperative day. The rupture rate of the anastomoses was statistically significantly higher in group 2 with early treatment compared to control group 1 (p < 0.05); no differences were observed between control group 3 and group 4 with delayed treatment (p > 0.05). Adhesion and abscess formation were more marked in group 2 compared to control group 1; no differences were recorded between groups 3 and 4. The anastomotic bursting pressure was statistically significantly lower in group 2 compared to control group 1 (p < 0.05); no differences were measured between groups 3 and 4. Histologic evaluation showed a more profound inflammatory response and less marked fibroblastic activity in group 2 compared to control group 1; new collagen production was more evident in group 1. No such differences were observed between groups 3 and 4. In conclusion, the immediate, postoperative, intraperitoneal administration of 5-fluorouracil plus folinic acid inhibited wound healing, but delaying chemotherapy (beginning on the 4th postoperative day) had no adverse effects on the healing of colonic anastomoses and can be considered safe.

This experimental study compares the effects of early postoperative administration of three enteral diets of different compositions on the healing of colonic anastomoses. Sixty Wistar rats were subjected to colonic anastomoses. Following surgery, the rats were randomly allocated to four groups of 15 each. The rats in control group A received an electrolyte and glucose solution, the rats in group B received a complete balanced nutrition, in group C a complete balanced nutrition supplemented with fiber and in group D an isocaloric specialized elemental nutrition enriched with glutamine. The rats were sacrificed on day 7 following operation. Rupture of the anastomosis was higher in rats of the control group compared to the other three groups. Adhesion formation was more extensive in group A in comparison to the other three groups. The anastomotic bursting pressures were statistically significantly higher in groups C and D compared to the other two groups (p < 0.05). There was no statistically significant difference between group C and D (p > 0.05) while a statistically significant difference was noted between group B and group A (p < 0.05). Histological examination showed more profound inflammatory reaction in group A compared to the other three groups. There was also a statistically significant difference between group B and groups C and D while inflammatory reaction was of no statistically significant difference between group C and group D. Healing of the anastomoses was statistically significantly impaired in group A compared to the other three groups. There was no statistically significant difference between group C and group D while a statistically significant difference was found between group B and groups C and D. In conclusion, early postoperative enteral feeding improves healing of experimental colonic anastomoses in rats. This effect was more evident when fiber-supplemented diets or diets enriched with glutamine were administered.

The purpose of this study was to determine whether delayed, postoperative, intraperitoneal treatment with 5-fluorouracil (5-FU) plus interferon-α-2a (IFN) has adverse effects on colonic healing, as does early treatment. Seventy male Wistar rats underwent colonic anastomoses. The rats were randomized to one of four groups. Early intraperitoneal injection was given to groups 1 and 2 which was repeated once daily for the first 3 postoperative days. Treatment was delayed in groups 3 and 4, from the 4th to the 7th postoperative day. A 0.9% NaCl solution was injected in the rats of control groups 1 and 3. In groups 2 and 4, we infused 5-FU (20 mg/kg/day) and IFN (45,000 IU/kg/day). All the animals were sacrificed on the 8th postoperative day. The anastomotic rupture rate was significantly higher in the rats of group 2 compared to control group 1 (p < 0.05), while there were no differences between groups 3 and 4 (p > 0.05). Abscess formation and adhesions were more frequent in group 2 compared to control group 1, while no differences were observed between groups 3 and 4. Anastomotic bursting pressure was statistically significantly lower in the rats of group 2 compared to group 1 (p < 0.05); no differences were noticed between groups 3 and 4 (p > 0.05). Simultaneous histologic evaluation showed a more profound inflammatory reaction and delayed anastomotic healing in group 2 compared to control group 1; there were, however, no differences between groups 3 and 4. In conclusion, the immediate, postoperative, intraperitoneal injection of 5-FU plus IFN impairs colonic healing while delayed treatment (starting on the 4th postoperative day) has no adverse effects on wound healing.

We present the results of combined, simultaneous application of sclerotherapy and rubber band ligation during one session in patients with symptomatic second-degree haemorrhoids. Between 1993 and 1996, 83 consecutive outpatients with second-degree haemorrhoids underwent simultaneous rubber band ligation of larger (primary) piles and sclerotherapy of smaller (secondary) piles. The treatment was successful, and the symptoms were controlled in 88% of the patients. The overall incidence of complications was 9.2%, but these were minor and transient. The simultaneous, combined sclerotherapy and rubber band ligation of second-degree haemorrhoids is a simple, safe, and effective method, with only minor and transient complications.

Intestinal ischemia-reperfusion (IIR) injury affects other organs, like the liver. Glutamine may offer liver protection, following IIR injury. Four groups of rats were studied. In Group A, the animals were subjected to 90 minutes of IIR. In Group B Alanyl-Glutamine dipeptide was administered prior to IIR. Group C, was the sham, and in Group D, the animals were given Alanyl-Glutamine dipeptide, only. Malondialdehyde, myeloperoxidase, and total glutathione were measured in liver tissue, and transaminases in the serum. Liver tissue samples were examined under electron microscopy. Malondialdehyde values in Groups A and B were significantly higher and total glutathione levels were significantly lower, compared to Groups C and D. SGPT values of Group A were significantly higher than Groups C and D. Electron microscopy examination of Group A animals showed endothelial cell degeneration. In Group B, hepatic cell changes were unremarkable. The administration of Alanyl-Glutamine dipeptide, prior to IIR, protected hepatocytes from oxidative injury.