Colonic anastomotic healing and oxygen tension

Shandall, A. A.; Lowndes, R. H.; Young, Honor

doi:10.1002/bjs.1800720808

Cited by 144 publications

(75 citation statements)

References 36 publications

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“…The theory stating that poor tissue perfusion increases the risk of anastomotic complications. In a series of animal and human models, the decrease in anastomotic tissue oxygen tension that causes changes in the healing process could be demonstrated (Shandall et al, 1985;Sheridan et al, 1987; Attard et al, 2005). The decrease in anastomotic intramucosal pH level increased risk of dehiscence and supports the theory that poor tissue perfusion of an anastomosis starts early and increases the risk of complications (Millan et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

Acidic Pelvic Drainage as a Predictive Factor For Anastomotic Leakage after Surgery for Patients with Rectal Cancer

Liu

Huang²,

Xu³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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considerable extra cost, increased in-hospital morbidity and mortality, impaired pelvic organ function (Eriksen et al., 2005; Law et al., 2007; Lee et al., 2008;Riss et al., 2011). Although there are multiple risk factors, such as being male, advanced age, severe obesity, lower tumor site (less than 4cm from the anal verge) and the reduction of TSGF in POD5, which are associated with anastomotic leakage have been reported in our previous study (Yang in individual patients on account of the absence of a early stage.The diagnosis of AL should be as early as possible for the sake of reducing its associated morbidity and mortality (Doeksen et al., 2007). Many studies on anterior resections regarding AL come from multi-center and different surgeons. A variety of factors predisposing to AL have been reported in the previous investigations. However, lack of data about the risk factors and incidence associated with AL from a single-institute of one team of doctors. Liu Yang et al 5442In addition, a great deal previous studies are repetitive works and duplicated effforts because of the limited power of innovative thinking. The pathophysiological processes and considering that interstitial acidic pH notion that extracellular acidosis may intensify the acute and extending its functional lifespan (Trevani et al., 1999; Martínez et al., 2006). The acidic microenvironments developing and the pelvic draining is becoming acidic, which is the main theoretical foundation for the present research. This study aimed to evaluate the utility of sequential postoperative pelvic drainage determinations of of AL after anterior resection of rectal cancer, which has not been reported ever before. Materials and MethodsBetween January 2004 and December 2011, 753 consecutive patients with rectal cancer underwent anterior resection with double stapling anastomosis for primary Jiangsu Cancer Hospital of Nanjing Medical University & Jiangsu Institute of Cancer Research, Nanjing, China. The medical notes of all patients were reviewed in detail.of TNM stage, histologically proven adenocarcinoma, open and laparoscopic surgery with pelvic drainage, all patients with 12 postoperative determinations of pH value, and antibiotics using for 7 PODs. Exclusion criteria were of TNM stage, colon cancer, hand-sewn anastomosis and perioperatively abdominopelvic implants that might be affect pH value, ongoing infection before surgery or an acquired infection in the postoperative period other the distance from the anal verge, as determined by rigid sigmoidoscopy. Total mesorectal excision was adopted as the standard surgical technique according to tumor location. The Ethics Committee of Science approved data collection in the register.All the patients were assigned to one of two groups according to the presence or absence of AL: with AL (Group AL, n=57), without AL (Group nAL, n=696). The two groups were compared according to the following characteristics: median age, gender, physical status (ASA score), the alcohol and tobacco abuse, tumor site, TNM stage, pre...

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Section: Discussionmentioning

confidence: 99%

Acidic Pelvic Drainage as a Predictive Factor For Anastomotic Leakage after Surgery for Patients with Rectal Cancer

Liu

Huang²,

Xu³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…Low oxygen tension (hypoxia) around the wound is one of several critical factors that mutually enhance the progression of a chronic ulcer, whereas a plentiful supply of oxygen is essential for a variety of the healing processes. Oxygen tension is positively correlated with collagen production (46,51,112), bacterial killing (17, 42, 61), epithelialization (131), and angiogenesis (62,63). All these components of wound healing increase greatly in well-oxygenated wounds.…”

Section: Fig 3 Enos-no-mmp-9-kitl Cascade-mediated Mobilization Of mentioning

confidence: 99%

Hyperoxia, Endothelial Progenitor Cell Mobilization, and Diabetic Wound Healing

Liu

Velázquez

2008

Antioxidants & Redox Signaling

240

178

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Diabetic foot disease is a major health problem, which affects 15% of the 200 million patients with diabetes worldwide. Diminished peripheral blood flow and decreased local neovascularization are critical factors that contribute to the delayed or nonhealing wounds in these patients. The correction of impaired local angiogenesis may be a key component in developing therapeutic protocols for treating chronic wounds of the lower extremity and diabetic foot ulcers. Endothelial progenitor cells (EPCs) are the key cellular effectors of postnatal neovascularization and play a central role in wound healing, but their circulating and wound-level numbers are decreased in diabetes, implicating an abnormality in EPC mobilization and homing mechanisms. The deficiency in EPC mobilization is presumably due to impairment of eNOS-NO cascade in bone marrow (BM). Hyperoxia, induced by a clinically relevant hyperbaric oxygen therapy (HBO) protocol, can significantly enhance the mobilization of EPCs from the BM into peripheral blood. However, increased circulating EPCs failed to reach to wound tissues. This is partly a result of downregulated production of SDF-1␣ in local wound lesions with diabetes. Administration of exogenous SDF-1␣ into wounds reversed the EPC homing impairment and, with hyperoxia, synergistically enhanced EPC mobilization, homing, neovascularization, and wound healing.

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“…As a biochemical parameter, the tissue collagen amount is determined through measurement of the level of the amino acid, hydroxyiproline (14). The bursting pressure, which indirectly shows the tissue collagen accumulation, is used as the mechanic method (15). Prolidase is the enzyme which degrades iminodipeptides involved in collagen production (4).…”

Section: Discussionmentioning

confidence: 99%