Healing of colonic anastomosis in rats  under obstructive ileus conditions

Despoudi, Kalliopi; Mantzoros, Ioannis; Ioannidis, Orestis; Loutzidou, Lydia; Christidis, Panagiotis; Chatzakis, Christos; Gkasdaris, Grigorios; Pramateftakis, Manousos George; Angelopoulos, Stamatios; Zaraboukas, Thomas; Koliakos, George; Tsalis, Konstantinos

doi:10.15190/d.2021.8

Cited by 3 publications

(4 citation statements)

References 57 publications

(89 reference statements)

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“…Still, no large abscesses or complete dehiscence with fecal peritonitis were found. Although using the bursting pressure is the most reliable method of mechanical power assessment of the anastomosis [29], the wide range of values in the literature and our study may suggest this method is not optimal for AL assessment.…”

Section: Discussionmentioning

confidence: 72%

Evaluation of the Effect of an Intraperitoneal Cytostatic-Loaded Supramolecular Hydrogel on Intestinal Anastomotic Healing in an Animal Model

Heuvelings,

Wintjens,

Jongen

et al. 2023

Life

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The prognosis of colorectal cancer patients with peritoneal metastases is very poor. Intraperitoneal drug delivery systems, like supramolecular hydrogels, are being developed to improve local delivery and intraperitoneal residence time of a cytostatic such as mitomycin C (MMC). In this study, we evaluate the effect of intraperitoneal hydrogel administration on anastomotic healing. Forty-two healthy Wistar rats received a colonic end-to-end anastomosis, after which 6 animals received an intraperitoneal injection with saline, 18 with unloaded hydrogel and 18 with MMC-loaded hydrogel. After 7 days, animals were euthanized, and the anastomotic adhesion and leakage score were measured as primary outcome. Secondary outcomes were bursting pressure, histological anastomosis evaluation and body weight changes. Twenty-two rats completed the follow-up period (saline: n = 6, unloaded hydrogel: n = 10, MMC-loaded hydrogel: n = 6) and were included in the analysis. A trend towards significance was found for anastomotic leakage score between the rats receiving saline and unloaded hydrogel after multiple-comparison correction (p = 0.020, α = 0.0167). No significant differences were found for all other outcomes. The main reason for drop-out in this study was intestinal blood loss. Although the preliminary results suggest that MMC-loaded or unloaded hydrogel does not influence anastomotic healing, the intestinal blood loss observed in a considerable number of animals receiving unloaded and MMC-loaded hydrogel implies that the injection of the hydrogel under the studied conditions is not safe in the current rodent model and warrants further optimalisation of the hydrogel.

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Section: Discussionmentioning

confidence: 72%

Evaluation of the Effect of an Intraperitoneal Cytostatic-Loaded Supramolecular Hydrogel on Intestinal Anastomotic Healing in an Animal Model

Heuvelings,

Wintjens,

Jongen

et al. 2023

Life

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“…In our study, no anastomosis leakage was observed post-euthanasia in either the control or the BromAc ® -treated rats. Previous studies using rat models showed very low incidences in control rats ranging, from 0–5% (0–1 out of 20 animals) [ 35 , 36 ]. A comparison of the burst pressure in the healing colon indicated no differences at 4 days after surgical intervention between the groups, and similar findings were observed at 13 days.…”

Section: Discussionmentioning

confidence: 99%

Intraperitoneal BromAc® Does Not Interfere with the Healing of Colon Anastomosis

Mekkawy

Breakeit

Pillai

et al. 2023

Cancers

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A combination of bromelain and acetylcysteine, BromAc®, is an efficient intraperitoneal mucolytic for thick mucus secreted in pseudomyxoma peritonei (PMP). Patients with PMP quite often undergo colon anastomosis. Hence, we investigated the effect of the intraperitoneal delivery of BromAc® on colon-anastomosis healing in a rat model. Sixteen Wistar rats were divided into two groups (N = 8). The controls received intraperitoneal saline after anastomosis, whilst the other group received BromAc®. They were monitored for body-weight and general health parameters. Half the rats in each group (N = 4) were culled at 4 or 13 days post-surgery for assessment. The healing process of the tissues was assessed by burst pressure and collagen density with histology to assess the integrity of the internal organs. The results indicated that there was a similar pattern of weight fluctuation during the experiment, although the rats treated with the BromAc® showed slightly greater weight loss during the first 4 days. Although the burst pressure was similar in both groups, the BromAc® group at day 13 showed a slightly higher burst pressure, which was complemented by a higher collagen density (albeit not statistically significant). The histology of the internal organs was comparable to those of the controls. This study indicates that the intraperitoneal delivery of BromAc® in a rat model does not interfere with the healing process of colonic anastomosis.

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“…The obstructive ileus condition was created by tying the colon 5 cm from the rectum with a non-absorbable 3.0 thread (Figure 1B), according to Despoudi models. 4 After 24 hours, a re-laparotomy was performed, an anastomotic resection was performed in the obstructed area (Figure 1C), and the rat colon was sutured in eight directions with a non-absorbable 6.0 thread; one surgeon performed all procedures (Figure 1D). The laparotomy wound was closed again (Figure 1E).…”

Section: Surgical Proceduresmentioning

confidence: 99%

“…2 More than 30% of patients with colorectal cancer present with obstructive ileus, of which 10% require urgent surgery, which is associated with an increased risk of AL. 3,4 One potential factor involved in AL is the degradation of the extracellular matrix (ECM), which provides structure and integrity to healthy intestinal tissues. Experimental studies investigating the relationship between matrix metalloproteinases (MMPs) and AL have concluded that MMPs negatively affect anastomotic healing.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Doxycycline on Matrix Metalloproteinase-9 Levels in the Colon of Wistar Rats with Obstructive Ileus

Ulfandi,

Labeda,

Syarifuddin

et al. 2024

imjm

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INTRODUCTION: Obstructive ileus after colonic anastomosis resection can increase leakage up to 2.5-fold. One possibility could be the extracellular matrix degradation, where matrix metalloproteinase-9 (MMP-9) negatively influences anastomotic healing. This study aimed to determine the effect of doxycycline on MMP-9 levels in the colon of experimental rats with obstructive ileus. MATERIALS AND METHODS: In this study, 28 male Wistar rats were selected randomly in a post-test control-group design comprising: Group A - control group, Group B - group without obstructive ileus given doxycycline, Group C - group with obstructive ileus not given doxycycline, and Group D - group with obstructive ileus given doxycycline. Doxycycline was given at a dose of 30 mg/kg. Groups C and D underwent anastomotic resection 24 hours following obstructive ileus procedure. Groups A and B underwent anastomotic resection at the same time as Groups C and D. Colonic tissue was collected to examine MMP-9 levels using an enzyme-linked immunosorbent assay (ELISA). Data were compared using Shapiro–Wilk tests, ANOVA, and Mann–Whitney U tests, and p<0.05 was considered significant. RESULTS: The results showed that the average MMP-9 levels increased with doxycycline treatment, [Group C (4.294 ± 0.226)], with significantly higher MMP-9 levels than Group A (1.017 ± 1.569, p<0.001). Group B did not differ significantly from Group A (p=0.848). MMP-9 levels differed significantly between Groups B and D (p<0.001), and between Groups C and D (p<0.001). CONCLUSION: Oral administration of doxycycline can attenuate increasing MMP-9 levels in Wistar rats with obstructive ileus

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Healing of colonic anastomosis in rats under obstructive ileus conditions

Cited by 3 publications

References 57 publications

Evaluation of the Effect of an Intraperitoneal Cytostatic-Loaded Supramolecular Hydrogel on Intestinal Anastomotic Healing in an Animal Model

Evaluation of the Effect of an Intraperitoneal Cytostatic-Loaded Supramolecular Hydrogel on Intestinal Anastomotic Healing in an Animal Model

Intraperitoneal BromAc® Does Not Interfere with the Healing of Colon Anastomosis

The Effect of Doxycycline on Matrix Metalloproteinase-9 Levels in the Colon of Wistar Rats with Obstructive Ileus

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