Improvement of Colonic Healing by Preoperative Rectal Irrigation With Short-Chain Fatty Acids in Rats Given Radiotherapy

Terzi, Cem; Sevinç, Ali İbrahim; Koçdor, Hilal; Oktay, Gülgün; Alanyalı, Hilmi; Küpelioğlu, Ali; Ergör, Gül; Füzün, Mehmet

doi:10.1007/s10350-004-0724-7

Cited by 22 publications

(47 citation statements)

References 31 publications

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“…They did not find differences in anastomotic strength or hydroxyproline content between the experimental and control groups. Recently, Terzi et al [20] showed that the anastomotic bursting pressure and hydroxyproline content were significantly reduced in rats that had received preoperative RT; however, clinical outcome was similar to that of the control. In the previous reports, the irradiation treatments were mostly applied in a single dose or in a limited number of fractions.…”

Section: Discussionmentioning

confidence: 99%

Effects of Two Conventional Preoperative Radiation Schedules on Anastomotic Healing in the Rat Colon

Bedirli¹,

Kerem²,

Karahacioglu

et al. 2007

Eur Surg Res

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Background: Preoperative radiotherapy (RT) is an increasingly popular form of adjunct therapy for rectal cancer; however, little is known about its effects on matrix metalloproteinase (MMP) expression in colonic anastomotic healing. Methods: Wistar rats were irradiated to a total dose of 25 or 40 Gy. Four days after the end of RT, an end-to-end colorectal anastomosis was performed. Animals were sacrificed at 1, 3, and 7 days after the anastomosis. A control group was studied similarly, but was not irradiated. Results: No significant differences were found in peritonitis rate and anastomotic complications. The average bursting pressure and breaking strength were only reduced significantly in the rats irradiated with 40 Gy. However, the concentration and the content of hydroxyproline in anastomotic tissues were unchanged. In irradiated rats, MMP-2 and MMP-9 were significantly increased at 40 Gy, but not at 25 Gy. On the other hand, 25-Gy irradiation induced a smaller increase in the levels of the tissue inhibitors of metalloproteinase-1 compared with the controls. Conclusion: Anastomotic strength is adversely affected by high-dose fractionated preoperative RT. In contrast, preoperative RT at 25 Gy in five fractions over 5 days is safe with regard to the maintenance of wound strength in colorectal anastomosis.

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Section: Discussionmentioning

confidence: 99%

Effects of Two Conventional Preoperative Radiation Schedules on Anastomotic Healing in the Rat Colon

Bedirli¹,

Kerem²,

Karahacioglu

et al. 2007

Eur Surg Res

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“…It is well known that during tissue healing, collagen molecules undergo various biochemical modifications, including hydroxylation and cross-linking [18] . On the other hand, cross-linking leads to resistance to solubilization (in both acid and salt), and therefore mature (insoluble) collagen contains higher amounts of cross-linking, whereas newly synthesized collagen (soluble) contains fewer cross-links and easily becomes soluble in salt and acid solutions [16,18,19] . Thus, as a part of the physiological component of wound healing, wound fluid (or seroma) may contain a small amount of soluble collagen [20][21][22] .…”

Section: Discussionmentioning

confidence: 99%

Effects of Locally Applied 5-Fluorouracil on the Prevention of Postmastectomy Seromas in a Rat Model

Koçdor¹,

Yildiz²,

Koçdor³

et al. 2007

Eur Surg Res

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Backgrounds: Seroma formation is the most common complication following mastectomy and axillary dissection (AD). Currently available interventions have aimed at obliterating dead space by inducing fibrosis and through various mechanical methods. Here, 5-fluorouracil (5-FU), used as a sclerosing agent for the prevention of seroma formation, was investigated in a rat mastectomy model. Methods: 20 rats were divided into two groups (5-FU and control). All rats underwent mastectomy and AD. Immediately following the operation, equal volumes of saline and 5-FU were administered under the surgical flaps. One week after the operation, seroma formation and wound-healing processes were evaluated using histopathological and biochemical investigations. Results: 5-FU did not act as a sclerosing agent, yet it was highly effective in preventing seroma formation. The intensity of acute inflammation, vascularity, as well as leukocyte and fibroblast infiltration, were significantly lower in the 5-FU group than the control; the tissue collagen fractions and total seroma collagen contents were found to be similar between the two groups. Conclusions: The mechanisms underlying seroma prevention by 5-FU are probably related to a decrease in the inflammation and angiogenesis rather than a local fibrotic process. Seroma formation may be due to a prolonged inflammatory phase of wound healing.

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“…Mild immunosuppressive action of 5-FU and the effect on peritoneal macrophages are also observed [24,25] . Preoperative radiotherapy has been linked with a weakening of colonic anastomosis but rectal irrigation with short chain fatty acids may improve anastomotic healing [26] . As evident by loss of mucosal integrity, presence of necrosis and granulocyte infiltration the healing around the anastomotic site was decreased.…”

Section: Discussionmentioning

confidence: 99%

Effect of 5-Fluorouracil and Mitomycin on the Healing of Intestinal Anastomosis

Shukla

Pandey²,

Das³

et al. 2007

Chemotherapy

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Objective: Antineoplastic agents affect the healing of intestinal anastomosis. The aim was to evaluate the effect of 5-fluorouracil (5-FU) and mitomycin on the healing of the intestinal anastomosis and their schedule of administration. Material and Methods: Eighty-nine male albino Charles Foster rats with a mean weight of 256.57 g were divided into six groups. Group A represents the control, while in others varying schedules of chemotherapy (5-FU and mitomycin) were administered. The sacrifices were made on days 7, 14 and 21 postoperatively and bursting pressure and hydroxyproline content were measured. Results: Nine rats died before completion of the experiment and were excluded. Adhesions were noted in all rats on sacrifice. The mean bursting pressure of normal intestine (group A) was 252 mm Hg. The bursting pressure was lower on day 7 (208 mm Hg) and it subsequently increased by day 21 (230 mm Hg). The mean bursting pressure in groups B, C, D and E was 174, 194, 182 and 188 mm Hg and it subsequently increased to 232, 272, 244 and 286 mm Hg. There was no difference in the pattern of bursting pressure in colon and ileum. The mean hydroxyproline content of ileum (group A) on day 7 was 34.37 mg/g tissue. The hydroxyproline content of the ileum in groups B, C, D and E was 15.08, 27.03, 7.75 and 21.04 mg/g tissue. There was a significant decrease in hydroxyproline content following anastomosis and chemotherapy. Conclusions: The effect of chemotherapy was pronounced when administered on the day of surgery or in the immediate pre- or postoperative period. Hence administration of chemotherapy during this period may be harmful.

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Improvement of Colonic Healing by Preoperative Rectal Irrigation With Short-Chain Fatty Acids in Rats Given Radiotherapy

Abstract: Some mechanical and histologic aspects of colonic anastomotic healing can be adversely affected by preoperative radiotherapy, but rectal irrigation with short-chain fatty acids may improve anastomotic healing.

Cited by 22 publications

References 31 publications

Effects of Two Conventional Preoperative Radiation Schedules on Anastomotic Healing in the Rat Colon

Effects of Two Conventional Preoperative Radiation Schedules on Anastomotic Healing in the Rat Colon

Effects of Locally Applied 5-Fluorouracil on the Prevention of Postmastectomy Seromas in a Rat Model

Effect of 5-Fluorouracil and Mitomycin on the Healing of Intestinal Anastomosis

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