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

Abstract

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.

Progress in Biological Research and Treatment of Pseudomyxoma Peritonei

“…They then verified its safety in a rat model, and the results showed that intraperitoneal injection of the combined agent was safe and had no significant impact on the healing of the colonic anastomosis. However, this study used a healthy rat model, and the impact on animal models under disease conditions is still unknown [154]. Following these positive preclinical findings, the team conducted a multicenter prospective phase II trial to investigate the clinical efficacy of bromelain in combination with NAC in patients with recurrent peritoneal mucinous tumors and PMP (NCT 03976973).…”