Effects of amniotic membrane on the healing of normal and high-risk colonic anastomoses in rats

Uludağ, Mehmet; Çıtgez, Bülent; Özkaya, Ozan; Yetkın, Gürkan; Özcan, Ömer; Polat, Nedim; İşgör, Adnan

doi:10.1007/s00384-009-0691-5

Cited by 24 publications

(43 citation statements)

References 41 publications

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“…In 1 study [27], 3 of 25 (12%) animals had perianastomotic abscess, 3 of 48 (6%) animals died from sepsis, and 4 of 48 (8%) animals were described as toxic; however, it was not stated if this was due to anastomotic leakage. Another study [28] using the same technique reported macroscopic signs of anastomotic leakage in 6 out of 9 (67%) animals and 5 of 9 (56%) animals had intra-abdominal abscess 7 days postoperatively. In contrast to these results, the last study [29] only reported 1 of 20 (5%) animals with intra-abdominal abscess.…”

Section: Animalsmentioning

confidence: 99%

Choosing the Best Animal Species to Mimic Clinical Colon Anastomotic Leakage in Humans: A Qualitative Systematic Review

Pommergaard

Rosenberg²,

Schumacher-Petersen³

et al. 2011

Eur Surg Res

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Background/Aims: Animal models are valuable for studying pathogenic factors and preventive measures for colon anastomotic leakage. The suitability of the species as models varies greatly; however, no consensus exists on which species to use. The aim of this review was to evaluate different experimental animals for the study of clinical colon anastomotic leakage. Methods: PubMed and REX database were searched up to October 2010 to identify studies evaluating clinical colon anastomotic leakage in animal models and textbooks on experimental animals, respectively. Results: Functional models of clinical colon anastomotic leakage have been developed in the mouse, pig, rat, dog and rabbit. However, extreme interventions are needed in order to produce clinical leakage in the rat. Conclusion: Despite the wide use of the rat in this field of research, it seems that its resistance to intra-abdominal infection makes clinical leakage difficult to produce thus rendering the rat unsuited as a model. On the basis of the available literature, we recommend using mice as models mimicking clinical colon anastomotic leakage. Pigs may be an alternative; however, the existing models in this animal are less validated and clinically relevant.

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Section: Animalsmentioning

confidence: 99%

Choosing the Best Animal Species to Mimic Clinical Colon Anastomotic Leakage in Humans: A Qualitative Systematic Review

Pommergaard

Rosenberg²,

Schumacher-Petersen³

et al. 2011

Eur Surg Res

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“…Materials such as GLU, short-chain fatty acids, erythropoietin, fibrin glue and peritoneal graft have been experimentally reported to be beneficial in the healing of colonic anastomoses. [1][2][3]10,14,15 ARG is a dietary semi-essential amino acid and it is metabolized to ornithine and subsequently to proline and polyamines both known to interact in collagen synthesis. 4,16 Dietary ARG supplementation increases wound collagen accumulation.…”

Section: Discussionmentioning

confidence: 99%

“…Although many local and systemic factors affecting anastomotic healing have been determined, AL is still a serious problem that significantly increases morbidity and mortality rates. 1 The prevalence of AL varies in the literature between 0.5% and 30%. 2,3 Therefore, research has focused on various systemically or locally applied materials that can improve anastomotic healing.…”

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confidence: 99%

“…2,3 Therefore, research has focused on various systemically or locally applied materials that can improve anastomotic healing. [1][2][3] Arginine (ARG) is a dietary semi essential amino acid that becomes conditionally indispensable in trauma and surgical patients. 4,5 Dietary ARG supplementation induces positive nitrogen balance, increases hydroxyproline (HP) content, wound collagen accumulation, shows antioxidative effect and enhances wound healing.…”

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confidence: 99%

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The Effect of a Special Amino Acid Mixture on Healing of Left Colonic Anastomosis: an Experimental Study

Yaman¹,

Kara²,

Derıcı³

et al. 2013

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Arginine, glutamine, and Beta-hydroxy-beta-methylbutyrate were combined in a dietary supplement. This specialized amino acid mixture enhances wound collagen accumulation and increases wound healing. We aimed to investigate the effects of this special amino acid mixture on the healing process of experimental left colonic anastomosis. M Ma at te er ri ia al l a an nd d M Me et th h--o od ds s: : The study included 20 adult male Wistar-Albino rats. The study group (n=10) received 685 mg/kg/day specialized amino acid mixture for 7 days until 12 h before surgery and was maintained throughout the study. Following midline laparatomy a 1-cm segment of the left colon was resected. Bowel continuity was restored with an end-to-end anastomosis. The animals were re-anesthetized on day 7 after the operation and anastomotic bursting pressure was measured by passing a catheter per anum up to the area of anastomosis. Anastomotic segments were removed en bloc and were vertically divided into two. One was used for hydroxyproline measurement and the other for histopathological examination. Abramov's histologic scoring system was used in this study. R Re es su ul lt ts s: : The hydroxyproline levels and bursting pressures in the study group were superior compared to the control group. Collagen deposition and reepithelization scores of the study group were higher than that of the control group. C Co on nc cl lu us si io on n: Results of the present study indicates that significantly enhancing the anastomotic bursting pressure, hydroxyproline level and collagen deposition may improve anastomosis healing.K Ke ey y W Wo or rd ds s: : Colorectal surgery; arginine; glutamine; beta-hydroxyisovaleric acid Ö ÖZ ZE ET T A Am ma aç ç: : Arjinin, glutamin ve beta-hidroksi-beta-metilbütirat, diyet desteği olarak kombine edilmiştir. Bu özel amino asit karışımı, yara yerinde kollajen birikimini artırır ve yara iyileşmesini geliştirir. Bu çalışmanın amacı, deneysel sol kolon anastomozunun iyileşmesinde özel amino asit karışımının etkilerini araştırmaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışmada 20 adet yetişkin Wistar-Albino sıçan kullanıldı. Çalışma grubu (n=10) ameliyattan 7 gün öncesinden başlayarak tüm çalışma süresince 685 mg/kg/gün özel amino asit karışımı aldı. Orta hattan karın açıldı ve 1 cm'lik sol kolon segmenti rezeke edildi. Uç-uca anastomoz yapılarak barsak lümeninin devamlılığı sağlandı. Sıçanlara bu ameliyattan 7 gün sonra tekrar anestezi verildi. Anastomoz patlama basıncı, anüsten yerleştirilip anastomozun üzerine çıkan bir kateter ile ölçüldü. Anastomoz sahaları sağlam sınırlarla çıkarıldı ve dikey olarak iki parçaya bölündü. Bir parça hidroksiprolin ölçümünde, diğer parça histolojik değerlendirmede kullanıldı. Histolojik değerlendirme için Abramov'un skorlama sistemi kullanıldı. B Bu ul lg gu ul la ar r: : Hiroksiprolin düzeyleri ve patlama basınçları çalışma grubunda, kontrol grubuna göre daha yüksekti. Kollajen birikimi ve reepitelizasyon skorları ç...

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“…The results of these clinical and experimental trials are often inconsistent and mostly not conclusive for definite promoting effects on anastomotic healing and safety ( table 4 ). Recently, biological extracellular collagenous matrices like small intestinal submucosa (SIS) and complex multilayer biological membranes like amniotic membrane have been tested with beneficial effects on anastomotic healing [12,13] . It is assumed especially in extracellular matrix that the 3-dimensional architectural structure of the fibrillar collagens in the naturally occurring biopolymers are a factor for promotion of structured tissue regeneration and gastrointestinal tissue healing [12,20] .…”

Section: Discussionmentioning

confidence: 99%

Reinforcement of Colonic Anastomoses with a Collagenous Double-Layer Matrix Extracted from Porcine Dermis

Hoeppner¹,

Willa²,

Timme

et al. 2010

Eur Surg Res

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Background: Anastomotic leakage is a major factor for morbidity in colorectal surgery. Anastomotic reinforcement with biological or synthetic materials has been claimed to be useful in preventing anastomotic leakage. Methods: We evaluated a non-cross-linked collagenous matrix Bio-Gide® (BG) for sealing colonic anastomoses in a rodent model. The animals were investigated for 4, 30 and 90 days. Macroscopic examination, histological examination and measurement of bursting pressure were performed. The anastomotic stricture rate was evaluated by radiographic contrast enema. Results: Microscopically anastomoses sealed by BG showed impaired anastomotic healing. Blood vessel ingrowth and collagen deposition were decreased without reaching significance after 4 days. The anastomotic bursting pressure was significantly decreased (p = 0.0454) in the early phase of healing. Anastomotic neovascularization was significantly decreased compared to the control group after 30 (p = 0.0058) and 90 days (p = 0.0275). Although no difference in anastomotic stricture rate was evident, the rate of intra-abdominal adhesions was significantly increased after 30 (p = 0.0124) and 90 days (p = 0.0281). Conclusion: BG failed to improve colonic anastomotic healing. Early anastomotic healing was impaired if anastomoses were reinforced with BG. BG did not affect the anastomotic stricture rate for up to 3 months; nevertheless, intra-abdominal adhesions were increased.

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Effects of amniotic membrane on the healing of normal and high-risk colonic anastomoses in rats

Abstract: The covering of both normal and high-risk colonic anastomoses with amniotic membrane provides a beneficial effect over conventional suturing of healing.

Cited by 24 publications

References 41 publications

Choosing the Best Animal Species to Mimic Clinical Colon Anastomotic Leakage in Humans: A Qualitative Systematic Review

Choosing the Best Animal Species to Mimic Clinical Colon Anastomotic Leakage in Humans: A Qualitative Systematic Review

The Effect of a Special Amino Acid Mixture on Healing of Left Colonic Anastomosis: an Experimental Study

Reinforcement of Colonic Anastomoses with a Collagenous Double-Layer Matrix Extracted from Porcine Dermis

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