Insulin-like growth factor I improves aspects of mycophenolate mofetil-impaired anastomotic healing in an experimental model

Inglin, Roman; Baumann, Gregor; Wagner, O; Candinas, Daniel; Egger, Bernhard

doi:10.1002/bjs.6053

Cited by 15 publications

(11 citation statements)

References 27 publications

(34 reference statements)

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“…Besides collagen formation, mucosal growth is a key factor in early healing of colonic anastomoses. The correlation between mucosal growth and mechanical stability of the anastomoses has been demonstrated in pertinent publications where anastomotic healing was assessed under different conditions. The present results show that mucosal thickness of the target segment of the colon was increased significantly in animals where the anastomosis was performed using oxygen‐producing suture material compared with the untreated off‐the‐shelf thread.…”

Section: Discussionsupporting

confidence: 66%

“…This can rightly be regarded as a flaw of the study. The authors did not include these data in the statistical analysis, as from previous experience a substantial difference in the clinically apparent leakage rate would not be expected between the different treatment groups in the experimental model used. Moreover, adhesions are not supposed to develop within the first 7 days after surgery, unless there is contained leakage or intra‐abdominal sepsis.…”

Section: Discussionmentioning

confidence: 99%

“…However, even though a leak might not yet be clinically evident at postoperative day 7, it can be assumed that the leak would have developed and, therefore, should be visible at death. Most, if not all, experimental studies on healing of intestinal anastomoses schedule the follow‐up within the first postoperative week.…”

Section: Discussionmentioning

confidence: 99%

“…After cutting the ischaemic bowel segment along its central part, anastomoses were performed by a single surgeon, as previously described, using the respective suture material in an inverted and interrupted fashion. The surgeon was not blinded to the assignment of the treatment groups.…”

Section: Methodsmentioning

confidence: 99%

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Effect of oxygen‐producing suture material on hypoxic colonic anastomoses in an experimental model

et al. 2019

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BackgroundAnastomotic leak remains a significant cause of morbidity and mortality after colorectal surgery. Among multiple risk factors considered, hypoxia–ischaemia is considered to be a primary cause of intestinal anastomotic leakage. The aim of this experimental study was to assess safety, usability for surgical tasks, and efficacy of a newly developed oxygen‐producing suture material in the healing of colonic anastomoses under critical conditions.MethodsAn oxygen‐producing suture material was produced that is capable of releasing oxygen directly into the surrounding tissue. Off‐the‐shelf sutures loaded with calcium peroxide nano‐crystals and covered with poly(d,l‐lactide‐co‐glycolide) were assessed in vitro and in a rat model of hypoxic colonic anastomosis.Results In vitro assessment showed that these sutures can increase oxygen levels in a hypoxic environment. Potential oxygen byproducts did not seem to have a negative impact on the viability of intestinal cells. The use of oxygen‐producing sutures in vivo resulted in increased tissue oxygen saturation, measured by visible light spectroscopy, and increased mechanical stability of the anastomosis.ConclusionOxygen‐producing suture material increased tissue oxygen saturation and mechanical stability of colonic anastomosis in a rat model.Surgical relevanceLeakage of anastomoses remains a significant problem after colorectal surgery.An oxygen‐producing suture material was produced that was shown to be safe in vitro and significantly improved several aspects of healing of colonic anastomoses in an animal model.Oxygen‐producing suture material or stapler devices might help to reduce the risk of anastomotic leak of intestinal anastomoses under physiological and critical conditions such as hypoxia.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Effect of oxygen‐producing suture material on hypoxic colonic anastomoses in an experimental model

et al. 2019

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“…The overall colonic leakage rate was at 2.4-3.5% according to previous clinical reports [1,2,3,4]. Some methods, such as omentoplasty [5], covering fibrin glue [6], matrix metalloproteases inhibitors [7], [8] and some exogenous agents [9,10,11,12,13] were experimented to decrease the leakage rate. De Hingh et al [14] constructed anastomosis in the distal ileum or distal colon of rats and found matrix metalloproteinases (MMPs) upregulated in the anastomosis postoperatively and Shaper et al [15] had similar results in performing anastomosis at the distal colon of rabbits.…”

Section: Introductionmentioning

confidence: 99%

Colonic Anastomosis with a Doxycycline-Coated Stent: An Experimental Study in a Porcine Model

Wang¹,

Cai²,

Mei³

et al. 2014

Dig Surg

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Background: Matrix metalloproteinases (MMPs) are supposed to be potential drug targets to prevent leakage after colonic anastomosis. A method of colonic anastomosis by using a stent coated with doxycycline, a MMP inhibitor, was developed and its safety and feasibility, as well as the effect of locally regulating MMPs, were evaluated by comparing with the conventional method or the method with a doxycycline-free stent. Methods: 48 pigs were assigned randomly to doxycycline-coated stent anastomosis group (DSA), doxycycline-free stent anastomosis group (SA), or conventional anastomosis group (CA). In each group, pigs were subdivided into four subgroups according to postoperative observation time (3, 7, 14, and 30 days). Healing of anastomosis and expressions of MMP-2/9 were evaluated. Results: No anastomotic leakage, stricture or necrosis was observed in the DSA group. No significant difference of bursting pressure was found between the DSA group and SA group. Relative expression of MMP-2 in the DSA group was significantly lower than in the SA group on postoperative days 3 and 7. No significant differences of hydroxyproline content, microvessel density and TGF-β₁ level were found in these groups. Conclusion: These results suggested this method was feasible and safe for colonic anastomosis with the advantage of locally inhibiting MMPs.

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Insulin-like growth factor 1-coated sutures improve anastomotic healing in an experimental model of colitis

Rijcken

Fuchs

Sachs

et al. 2010

British Journal of Surgery

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Insulin-like growth factor I improves aspects of mycophenolate mofetil-impaired anastomotic healing in an experimental model

Abstract: Exogenous IGF-I improves some aspects of MMF-impaired anastomotic healing.

Cited by 15 publications

References 27 publications

Effect of oxygen‐producing suture material on hypoxic colonic anastomoses in an experimental model

Effect of oxygen‐producing suture material on hypoxic colonic anastomoses in an experimental model

Colonic Anastomosis with a Doxycycline-Coated Stent: An Experimental Study in a Porcine Model

Insulin-like growth factor 1-coated sutures improve anastomotic healing in an experimental model of colitis

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