Does metoclopramide impair anastomotic healing of the left colon of rats?

Abstract

Purpose:To evaluate the effects of metoclopramide on the formation of adhesion and the healing of left colonic anastomoses in rats. Methods: Forty rats underwent sectioning of the left colon and end-to-end anastomosis and were divided into two groups of 20 animals for the administration of metoclopramide (experimental group -E) or saline solution (control group -C). Each group was divided into subgroups of 10 animals each to be killed on the third (E3 and C3) or seventh postoperative day (E7 and C7). Adhesion was assessed, and a colonic segment containing the anastomosis was removed for analysis of breaking strength and hydroxyproline concentration. Results: There were no deaths or dehiscence on the 3 rd postoperative day. There was one death and one blocked anastomotic dehiscence in the E7 group. No significant differences between groups were found in the analysis of clinical outcome, intra-cavity adhesion, adhesion to the anastomosis or breaking strength on the 3 rd and 7 th postoperative day. Hydroxyproline concentration was higher in the control group on the 3 rd (p=0.006) but not on the 7 th postoperative day (p=0.241). Conclusion: Metoclopramide did not have harmful effects on the healing of intestinal anastomoses in rats. Key words: Anastomosis, Surgical. Colon. Metoclopramide. Gastrointestinal Motility. Tissue Adhesions. Rats. RESUMOObjetivo: Avaliar os efeitos da metoclopramida sobre a formação de aderências e a cicatrização de anastomoses de cólon esquerdo de ratos. Métodos: 40 ratos distribuídos em dois grupos contendo 20 animais, para administração de metoclopramida (grupo experimental -E) ou solução de NaCl 0,9% (grupo controle -C). Cada grupo foi dividido em subgrupos contendo 10 animais, para eutanásia no terceiro (E3 e C3) ou sétimo dia (E7 e C7) de pós-operatório. Os ratos foram submetidos à secção do cólon esquerdo e anastomose término-terminal. No dia da re-laparotomia foi avaliada a quantidade total de aderências e removido um segmento colônico contendo a anastomose para análise da força de ruptura e concentração de hidroxiprolina. Resultados: Não houve mortes ou deiscências no 3° dia de pós-operatório. No grupo E7 ocorreram uma morte e uma deiscência de anastomose bloqueada. Não houve diferença significativa entre os grupos em relação à evolução clínica, quantidade de aderências intra-cavitárias ou à anastomose e resistência tênsil no 3° ou 7° pós-operatório. A concentração de hidroxiprolina foi maior no grupo metoclopramida no 3° (p=0,006) mas não no 7° dia de pós-operatório (p=0,241) Conclusão: A metoclopramida não apresenta efeito deletério sobre a cicatrização de anastomoses intestinais em ratos.

Evaluation of the effects of S-methylisothiourea hemisulfate, an inducible nitric oxide synthase inhibitor, on the healing of colonic anastomosis in rats

“…Others reported weight recovery as early as the seventh POD 17 . The increase in breaking strength found with the passing of the PO period in both groups corroborates other studies in the literature 18 . The lack of a statistically significant difference on the third POD might be because the operated area is kept together by the suture during this period 19 …”

Effects of metoclopramide on the expression of metalloproteinases and interleukins in left colonic anastomoses. An experimental study

“…Although the difference was not statistically significant, we noted that, in the absence of peritoneal sepsis, the anastomoses of metoclopramidetreated animals had lower anastomotic breaking strength on the 3rd POD and higher values on the 7th POD, compared to saline solution-treated controls 19 . This might be explained in the present study by the increased expression of MMP-1a and MMP-13 on the 3rd POD and the subsequent negative modulation of all MMPs on the 7th POD in the anastomoses of all metoclopramide-treated animals.…”

“…In previous studies, we found that metoclopramide had no harmful effects on the healing of intestinal anastomoses in rats in the presence 18 or absence 19 of abdominal sepsis after tensile strength testing, measurement of hydroxyproline levels, histomorphometric evaluation of collagen, and histopathological analysis. Although the difference was not statistically significant, we noted that, in the absence of peritoneal sepsis, the anastomoses of metoclopramidetreated animals had lower anastomotic breaking strength on the 3rd POD and higher values on the 7th POD, compared to saline solution-treated controls 19 .…”

Effects of bromopride on the healing of left colonic anastomoses in rats with induced abdominal sepsis

“…García-Olmo et al 16 evaluated the effects of pharmacological manipulation of gastrointestinal motility on the resistance of colonic anastomoses and concluded that treatment with metoclopramide was associated with fewer adhesions to the anastomosis and a significant decrease in anastomotic resistance four days after surgery. In another study 17 , metoclopramidetreated animals showed adhesion formation within the abdominal cavity and in the anastomosis similar to that of animals receiving saline three and seven days after surgery. Likewise, tensile strength of anastomoses was similar across subgroups, but hydroxyproline concentration on postoperative third day was higher in metoclopramide-treated animals than in controls.…”