Effects of Renal Dysfunction on Healing of Colonic Anastomosis: Experimental Study in Wistar Rats

Abstract

Background: Chronic kidney disease affects more than 500 million people worldwide. In this context, the uremic toxins present are related to worsening in tissue healing. Aim: Evaluate on healing of colonic anastomosis in uremic rats, serum and anatomopathological indicators, which may be related to the change tissue repair process. Methods: Twenty Wistar rats, were randomly separated into two groups. In the sham group they were submitted to 5/6 nephrectomy simulation in left kidney, simulation right nephrectomy, median laparotomy, colotomy and colorraphy. In the uremia group, they were submitted to 5/6 nephrectomy of the left kidney, total nephrectomy of the right kidney and median laparotomy, colotomy and colorraphy. Were collected for serum urea, creatinine and CRP dosages and the colonic segments were studied for evaluation of granulation tissue, collagen maturation, microvascular and myofibroblasts density, and cell viability. Through histochemical processing, microvascular density was evaluated by anti-CD34 monoclonal antibody marking, cell viability by cell proliferation nuclear antigen screening and myofibroblasts density with monoclonal anti-α-actin antibody. Computerized histometry was used for evaluations of collagens type I and III by the coloration of picrosirius. Results: The group submitted to nephrectomy 5/6, compared to the sham group, show urea increase (p<0.0000) and higher C reactive protein (p=0.0142). Decrease of granulation tissue formation (border reepithelialization p=0,0196, angiofibroblast proliferation p=0.0379), mean collagen I (p=0,0009) and collagen III (p=0,016), microvascular density (p=0,0074), cell proliferation nuclear antigen (p<0,0000) and myofibroblasts (p<0,0001). Conclusion: The uremia induced by nephrectomy 5/6 model establishes negative impact in the colonic wound healing.

Is There a Difference Between Right- Versus Left-Sided Colon Cancers? Does Side Make Any Difference in Long-Term Follow-Up?

“…This it may well be to the different embryologic development of the two segments of the colon, which may represent two separate disease entities 3 . These differences might have consequences for the treatment of patients with colorectal cancer 33 .…”

Is Superficial Colorectal Lesions With Low and High Grades Intraepithelial Neoplasms More Prevalent in Older Above 65 Years?

“…Superficial lesions are often flat or slightly elevated and some have lateral growth4. Colonoscopy has been used as a screening, diagnosis and treatment method 9,22 and represents the only means that can reduce the incidence of colorectal cancer allowing lesions resections 14 , 18 . The detection of superficial lesion in asymptomatic patients undergoing colonoscopy is frequent and varies between 10-60% 17 .…”

Fatores de risco para mediastinite em cirurgia de revascularização do miocárdio em hospital de referência / Risk factors for mediastinitis in myocardial revascularization surgery in reference hospital

“…12 A IRC foi outro fator de risco avaliado, e se apresenta como um dos fatores de risco de menor acometimento diante da população de estudo, corroborando com estudo 10 , porém vale ressaltar que na sua presença há retardo do processo inflamatório cicatricial pela baixa proliferação de fibroblastos, células endoteliais, colágeno, tecido conectivo subcutâneo e tecido de granulação. 21 A FEVE<40% ganha relevância partindo do pressuposto que o débito cardíaco reduzido proporciona uma inapropriada perfusão tecidual, prejudicando o processo cicatricial que é oxigênio dependente. 17 Medidas de prevenção sobre os fatores de risco controláveis devem ganhar atenção com a finalidade evitar complicações preveníveis.…”