Healing of Colon Anastomoses Covered With Fibrin Glue After Immediate Postoperative Intraperitoneal Administration of 5-Fluorouracil

Kanellos, Ioannis; Mantzoros, Ioannis; Demetriades, H.; Kalfadis, Stavros; Kelpis, Timotheos G.; Sakkas, Leonidas; Betsis, D.

doi:10.1007/s10350-003-0085-7

Cited by 57 publications

(75 citation statements)

References 22 publications

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“…Colonic bursting pressure is a sign of the mechanical endurance of the anastomosis 35 . In a study by Xiao H. et al 36 the impact of a carboxymethylchitosan-carboxymethylcellulose (CMCH-CMC) film applied to the surface of anastomosis on wound healing was explored in rats.…”

Section: Comparison Of Chitosan and Control Groups Three And Seven Damentioning

confidence: 99%

Effects of chitosan on healing and strength of colonic anastomosis in rats

Çıtgez¹,

Cengiz²,

Akgün³

et al. 2012

Acta Cir. Bras.

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PURPOSE:To investigate whether chitosan application over colonic anastomosis line, provide reinforcement, and subsequently improve anastomotic healing. METHODS:Forty eight Wistar albino female rats were used and were randomly divided into four groups, 12 rats in each: The control groups (1 and 3) received no further treatment. The experimental groups (2 and 4) received chitosan application over the colonic anastomosis. After sacrifying rats at the end of the experiment (either on day three or on day seven, depending on the group), colonic bursting pressure, a hihydroxyproline level and histopathologic characteristics of the perianastomotic tissue were examined. RESULTS:At three days, chitosan and control groups had similar values for histopathologically. On day seven, chitosan group had significantly higher mean score of collagenization (p=0.007) and a significantly higher bursting pressure (p=0.038). CONCLUSION:Our study emphasizes the positive effect of chitosan in the process of collagenation in colonic anastomosis healing. Key words: Chitosan. Anastomosis, Surgical. Tensile Strength. Wound Healing. Rats. RESUMO OBJETIVO:Investigar se a aplicação de quitosana em anastomose colônica promove resistência à tração e consequentemente a melhora na cicatrização. MÉTODOS:Foram utilizados 48 ratos Wistar fêmeas distribuídos em quatro grupos, 12 ratos em cada. Grupos controle (1 e 3) não receberam tratamento. Grupos experimento (2 e 4) receberam aplicação de quitosana na anastomose colônica. Após eutanásia após 3º ou 7º dias foram examinadas a tensão, o nível de hidroxiprolina e aspectos histopatológicos da anastomose. RESULTADOS:Após três dias os grupos controle e quitosana não apresentaram alterações histopatológicas. No sétimo dia o grupo quitosana apresentou significante elevação do escore de colagenização (p=0,007) e da tensão de ruptura (p=0,038). CONCLUSÃO:A quitosana apresentou bons resultados nos processos de colagenização e cicatrização de anastomose colônica.Descritores: Quitosana. Anastomose Cirúrgica. Resistência à Tração. Cicatrização. Ratos.Citgez B et al.

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Section: Comparison Of Chitosan and Control Groups Three And Seven Damentioning

confidence: 99%

Effects of chitosan on healing and strength of colonic anastomosis in rats

Çıtgez¹,

Cengiz²,

Akgün³

et al. 2012

Acta Cir. Bras.

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“…Injections were repeated until the 6th postoperative day (a total of 7). In previous studies, the number of injections ranged from 2 to 7 after surgery [5,6,7,8,10,17]. We chose the maximum number of injection to allow for an adequate contrast in collagen regeneration rates between groups C and M. Because of this, we accepted a higher mortality rate for group M.…”

Section: Methodsmentioning

confidence: 99%

“…Immediately after operation, 20 mg/kg 5-FU with saline (concentration of 5 mg/ml) was injected intraperitoneally in the M group rats and was continued for 7 days, which is a dosage used in previous studies [5,6,7,8]. In the control group, normal saline was administered at 1 ml/100 mg/day.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, the use of chemotherapeutic agents like 5-fluorouracil (5-FU) to destroy cancer cells that might have been disseminated during operation [4] has an adverse effect on the healing of colonic anastomoses [5,6,7]. In particular, 5-FU has been shown to have a negative effect on the ability of fibroblasts to proliferate and synthesize collagen [4,7,8], which is essential for wound healing after colon anastomosis [9]. On the other hand, various studies have concluded that intraperitoneally administered 5-FU does not affect anastomosis healing [10].…”

Section: Introductionmentioning

confidence: 99%

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The Use of Collagen Content as Determined by Spectral Domain Polarization-Sensitive Optical Coherence Tomography to Assess Colon Anastomosis Healing in a Rat Model

Son

Jeong²,

Jung

et al. 2014

Eur Surg Res

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Background/Purpose: Many studies have been undertaken to prevent anastomosis leakage of the colon, and several methods have been used to assess anastomosis healing, such as measurement of bursting pressure or hydroxyproline (a marker of collagen) content at the anastomosis site. However, these methods are inappropriate for comparing anastomosis healing at two time points in the same animals. In the present study, we measured the collagen level by spectral domain polarization-sensitive optical coherence tomography (SD-PS-OCT) to assess anastomosis healing. Methods: Sprague-Dawley rats were divided into groups C (saline-administered controls; study group) and M [a 5-fluorouracil (5-FU)-administered experimental group]. Immediately after end-to-end anastomosis of the colon, SD-PS-OCT images of anastomoses were taken (baseline). Animals were administered saline or 5-FU for 7 days. On the 7th postoperative day, SD-PS-OCT images were acquired, a histopathologic exam was performed, and hydroxyproline levels as well as mRNA expressions of collagen-1 and collagen-3 were measured at the anastomosis site. Results: Fibroblast proliferation and inflammatory cell infiltration were greater in group C than in group M. The mRNA expressions of collagen-1 and collagen-3 were substantially higher in group C. Hydroxyproline levels were higher in group M than in group C. Though collagen levels measured by SD-PS-OCT at 7 days were elevated compared with baseline in group C, no such changes were observed for group M. Conclusion: Collagen levels at the colon anastomosis site, measured with SD-PS-OCT, were not increased at 7 days postoperatively versus baseline when 5-FU was injected, but were increased in saline-treated controls. The measurement of collagen content by SD-PS-OCT was found to provide a good means of assessing anastomosis healing, because it allows in situ assessment of collagen contents at baseline and during the postoperative period.

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“…O adesivo cirúrgico BioGlue poderia ser útil nas anastomoses digestivas, promovendo uma barreira física em torno das mesmas, diminuindo as taxas de deiscência no período pós-operatório, aumentando a resistência mecânica e a pressão de ruptura 21 . A principal indicação do adesivo cirúrgico BioGlueÒ tem sido na hemostasia adjuvante aos méto-dos padrões (tais como suturas, grampeadores), nas cirurgias abertas de reparo de grandes vasos (tais como aorta, femoral e carótida) em pacientes adultos 21 . Não identificamos na literatura pesquisada, estudos avaliando os efeitos dos adesivos teciduais à base de albumina-glutaraldeido nas anastomoses colônicas.…”

Section: Introductionunclassified

Influência da cola Bioglue® na deiscência de anastomose colônica: estudo experimental

Lucena

Mathias

Filho

et al. 2007

Rev bras. colo-proctol.

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RESUMO: A grande parte da morbimortalidade associada com a cirurgia colorretal, é associada com a deiscência anastomótica. Trabalhos experimentais sobre a utilidade de adesivos tissulares nas anastomoses colônicas são controversos, assim como estudos clínicos prospectivos randomizados são ausentes. O adesivo cirúrgico BioGlue    , formado por dois componentes -albumina sérica bovina purificada e glutaraldeído, forma uma ligação co-valente entre esses dois componentes e as proteínas teciduais no local de aplicação. O objetivo do estudo é avaliar a eficácia da BioGlue     na prevenção da deiscência anastomótica colônica em ratos. Foram utilizados 30 ratos machos da raça Wistar albino. A anastomose colocolônica foi confeccionada com sutura em pontos separados com polipropileno 5-0 (grupo 1) e aplicação da cola BioGlue     envolvendo a anastomose (grupo 2). Avaliaram-se a formação e extensão das aderências, a pressão de ruptura nas anastomoses e as alterações histológicas. Apenas um animal do grupo 1 (7%) faleceu, sendo constatada na necropsia, obstrução intestinal com grande distensão de alças. A mortalidade no grupo 2, por outro lado, foi de 10 animais (67%), sendo observado: distensão de alças intestinais, vazamento anastomótico e, em algumas situações, franca peritonite fecal por deiscência quase que total da anastomose. O presente trabalho nos permitiu concluir que, o uso da Bioglue® nas anastomoses colônicas realizadas em ratos, promoveu um aumento na morbimortalidade que foi estatisticamente significante comparado à sutura convencional.

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Healing of Colon Anastomoses Covered With Fibrin Glue After Immediate Postoperative Intraperitoneal Administration of 5-Fluorouracil

Abstract: The immediate postoperative, intraperitoneal administration of 5-FU inhibited wound healing. However, when the colonic anastomoses were covered with fibrin glue, the injection of 5-FU had no adverse effects on the healing of the anastomoses.

Cited by 57 publications

References 22 publications

Effects of chitosan on healing and strength of colonic anastomosis in rats

Effects of chitosan on healing and strength of colonic anastomosis in rats

The Use of Collagen Content as Determined by Spectral Domain Polarization-Sensitive Optical Coherence Tomography to Assess Colon Anastomosis Healing in a Rat Model

Influência da cola Bioglue® na deiscência de anastomose colônica: estudo experimental

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