Effects of hyperglycemia and ageing on the healing of colonic anastomoses in rats

Abstract

Introduction:Despite the significant advances in the knowledge of the healing process, there is a limited number of studies demonstrating the relationships of this healing with ageing and elevated levels of glycemia. Purpose: To evaluate the effects of ageing and hyperglycemia on the healing of colonic anastomosis. Methods: 138 young and old male rats were utilized. Some of them were normoglycemic and others had hyperglycemia induced by streptozocin (50mg/kg). They were maintained under control for 90 days. They were then submitted to a termino-terminal anastomosis in the left colon. On the third, seventh and fourteenth days after surgery, their resistance was evaluated and a histopathological study of the anastomosis was carried out. Results: Gain in resistance was similar for both groups. The additive effect of age with hyperglycemia made a significant difference to the collagen I (p<0.001), III (p=0.022) and total (p<0.001). Among the old animals, the glycemia was a determining factor for the occurrence of a significant difference in total collagen (p=0.029) and collagen I (p=0.013). Among the normoglycemics, age determined a lower density of collagen I (p=0.002). Conclusion: There is delayed collagen synthesis and maturation of the scars of older animals, a situation that becomes more serious in older hyperglycemic animals, but insufficient to adversely affect the gain in resistance. Key words: Diabetes Mellitus, Experimental. Hyperglycemia. Collagen. Wound Healing. Colon. Anastomosis, Surgical. RESUMO Introdução: Apesar dos significantes avanços no conhecimento do processo cicatricial há um restrito número de estudos demonstrando as relações deste reparo com o envelhecimento e com níveis elevados de glicemia. Objetivo: Avaliar os efeitos do envelhecimento e da hiperglicemia na cicatrização de anastomoses colônicas. Métodos: Utilizaram-se 138 ratos machos, adultos jovens e velhos. Parte deles era normoglicêmico e parte teve hiperglicemia induzida pelo streptozocin (50mg/kg). Foram mantidos controlados por 90 dias. Após fez-se uma anastomose término-terminal no cólon esquerdo. No 3.º, 7.º e 14.º dia de pós-operatório avaliou-se a resistência e fez-se o estudo histo-patológico da anastomose. Resultados: O ganho de resistência foi semelhante entre os grupos. O efeito aditivo da idade com a hiperglicemia determinou diferença significativa nos colágenos I (p<0,001), III (p=0,022) e total (p<0,001). Entre os velhos a glicemia foi determinante para ocorrer diferença significativa no colágeno total (p=0,029) e colágeno I (p=0,013). Entre os normoglicêmicos a idade determinou menor densidade de colágeno I (p=0,002). Conclusão: Existe atraso na síntese do colágeno e na maturação das cicatrizes nos animais velhos, situação que se agrava nos animais velhos e hiperglicêmicos, não suficiente para prejudicar o ganho de resistência. Descritores: Diabetes Mellitus Experimental. Hiperglicemia. Colágeno. Cicatrização de Feridas. Colo. Anastomose Cirúrgica.

Influence of arterial hypertension on colonic healing in rats

“…Despite the lower concentration of collagen, the aging did not increase the risk of left colon anastomoses in Wistar rats 12,16 , nevertheless, still turned away from the influence of aging on the anastomosis studied, opting for the young animals.…”

“…In another study the proportion was 10%, 15% and 29% on the third, seventh and fourteenth day after surgery, respectively 16 .…”

“…Biondo-Simões et al 16,18 observed progressive gain of collagen in the anastomosis area on the fourth, seventh and fourteenth days after surgery for bowel suture in Wistar rats in the control group. Tostes et al 17 measured the concentration of hydroxyproline in the abdominal wall of SHR rats subjected to laparotomy, obtaining the progressive concentration of hydroxyproline, which is a good marker of the amount of collagen in tissue 36 , on the seventh and fourteenth day after surgery.…”

Dual Inhibition of Wound Healing and Oxidative Process by Montelukast in Experimental Colon Anastomoses

“…1,2 Extensive research has focused on the healing of the colon anastomosis and resulted in improvements in anastomotic healing with local and systemic agents, including growth factors. [3][4][5][6] Even though progress has been made, anastomotic dehishence following colon anastomosis is still a serious surgical complication. 7 Montelukast (ML) is a potent selective antagonist of the cysteinyl leukotriene receptors 1 (CysLT1R) developed as oral treatment for adults and children with asthma.…”