Pharmacological interventions for improved colonic anastomotic healing: A meta-analysis

Øines, Mari Nanna; Krarup, Peter‐Martin; Jørgensen, Lars N.; Ågren, Magnus S.

doi:10.3748/wjg.v20.i35.12637

Cited by 43 publications

(47 citation statements)

References 96 publications

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“…Studies have demonstrated many options and parameters to achieve the best results in intestinal healing. Animal models, surgical techniques, pharmaceutical interventions and different segments of GI tract have been tested and demonstrated different results 14,28 . Øines et al 28 in a recent meta-analysis identified seven therapeutic agents for improve the colonic anastomotic healing and that could be explored further.…”

Section: Strategies For Healing Improvement Of Colorectal Anastomosismentioning

confidence: 99%

“…Animal models, surgical techniques, pharmaceutical interventions and different segments of GI tract have been tested and demonstrated different results 14,28 . Øines et al 28 in a recent meta-analysis identified seven therapeutic agents for improve the colonic anastomotic healing and that could be explored further. They stratified the agents in four categories: immunomodulators, miscellaneous, proteinase inhibitors and growth hormone (GH) factors.…”

Section: Strategies For Healing Improvement Of Colorectal Anastomosismentioning

confidence: 99%

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Ghrelin and gastrointestinal wound healing. A new perspective for colorectal surgery

et al. 2018

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Section: Strategies For Healing Improvement Of Colorectal Anastomosismentioning

confidence: 99%

Section: Strategies For Healing Improvement Of Colorectal Anastomosismentioning

confidence: 99%

Ghrelin and gastrointestinal wound healing. A new perspective for colorectal surgery

et al. 2018

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“…Furthermore, in the recently published guidelines of the European Society for Clinical Nutrition and Metabolism, teduglutide was considered the first choice for carefully selected patients with chronic intestinal failure who are candidates for growth factor treatment 8 . Several experimental studies, analyzing intestinal anastomotic repair-promoting methods, have suggested potential benefits from growth factors administration, including from insulin-like growth factor 1, epidermal growth factor, heparin-binding epidermal growth factor and fibroblast growth factor-7/ keratinocyte growth factor 9,10 , which have been considered mediators of the GLP-2 effects 1 . In fact, a recently published study demonstrated, through histological and immunohistochemical inflammatory and proliferative stages of the intestinal anastomotic repair 9,12 ), with ileal harvesting and blood collection.…”

Section: ■ Introductionmentioning

confidence: 99%

Intestinal inflammatory and redox responses to the perioperative administration of teduglutide in rats

et al. 2017

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1 AbstractPurpose: To investigate the inflammatory and redox responses to teduglutide on an animal model of laparotomy and intestinal anastomosis. Methods: Wistar rats (n=62) were allocated into four groups: "Ileal Resection and Anastomosis" vs. "Laparotomy", each one split into "Postoperative Teduglutide Administration" vs. "No Treatment"; and euthanized at the third or the seventh day. Ileal and blood samples were recovered at the baseline and at the euthanasia. Flow cytometry was used to study the inflammatory response (IL-1α, MCP-1, TNF-α, IFN-γ and IL-4 levels), oxidative stress (cytosolic peroxides, mitochondrial reactive species, intracellular glutathione and mitochondrial membrane potential) and cellular viability and death (annexin V/propidium iodide double staining). Results: Postoperative teduglutide treatment was associated with higher cellular viability index and lower early apoptosis ratio at the seventh day; higher cytosolic peroxides level at the third day and mitochondrial overgeneration of reactive species at the seventh day; higher tissue concentration of IL-4 and lower local pro-to-anti-inflammatory cytokines ratio at the seventh day. Conclusion: Those findings suggest an intestinal pro-oxidative and anti-inflammatory influence of teduglutide on the peri-operative context with a potential interference in the intestinal anastomotic healing.

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“…The development of post-operative anastomotic leak is one of the most concerning complications in colorectal resection surgery as it is associated with negative patient outcomes including increased risk of abscess or fistula development, greater incidence of infection or sepsis, prolonged hospital stays and a greater risk of post-operative mortality [2,[4][5][6][7]. Patients who experience anastomotic leak following colorectal resection surgery are also at an increased risk of cancer recurrence, impaired function of pelvic organs, and a permanent stoma [5,8].…”

Section: Introductionmentioning

confidence: 99%

Estimated Rate of Post-Operative Anastomotic Leak Following Colorectal Resection Surgery: A Systematic Review

Schiff¹,

Brady²,

Ghosh³

et al. 2016

J Surg Surgical Res

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Purpose: Anastomotic leak following colorectal resection surgery is associated with short and long-term negative patient outcomes, prolonged hospitalization, and increased healthcare costs. Various patient related and surgical factors are known to contribute to the development of postoperative anastomotic leaks. This study systematically reviewed the literature to assess the incidence of post-operative leak and identify patient factors associated with the development of leaks. Methods:Articles published from 1/1/2003 -8/8/2015 reporting on post-operative anastomotic leak following colorectal resection surgery were identified in the Medline and Embase databases. The rate of post-operative leak, as well as patient and surgical characteristics, were extracted.Results: Forty-three articles met study inclusion criteria. Within the 14,102 cases, 867 patients experienced anastomotic leak, yielding an average leak rate of 6.1%. Patients were primarily male (57.0%) and had a mean age of 60.2 years. The majority of patients received a stapled anastomosis (70.9%), and most resection surgeries were performed for a diagnosis of cancer (80.7%). Comparison of patient characteristics with and without a post-operative leak revealed male gender, diabetes, open surgical procedures, and sutured anastomoses to be risk factors of anastomotic leak. Patients with anastomotic leak had a longer length of stay in the hospital and higher mortality rate than patients without a leak. Conclusions:Anastomotic leak remains a major concern in colorectal resection surgery and occurs in approximately 6.1% of cases. Both patient and surgical factors are associated with the development of post-operative anastomotic leak, which is linked to negative patient outcomes and increased mortality.

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Pharmacological interventions for improved colonic anastomotic healing: A meta-analysis

Abstract: This systematic review identified only one randomized clinical trial and seven therapeutic agents from pre-clinical models that could be explored further for the prophylaxis of AL after colorectal surgery.

Cited by 43 publications

References 96 publications

Ghrelin and gastrointestinal wound healing. A new perspective for colorectal surgery

Ghrelin and gastrointestinal wound healing. A new perspective for colorectal surgery

Intestinal inflammatory and redox responses to the perioperative administration of teduglutide in rats

Estimated Rate of Post-Operative Anastomotic Leak Following Colorectal Resection Surgery: A Systematic Review

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