Platelet-rich plasma role in the local protection of the colon anastomosis

Abstract

Introduction. Intestinal anastomosis dehiscence has been and remains a critical problem in modern colorectal surgery, associated with significant morbidity and mortality. Currently, there are various studies focused on the development of a method to protect the intestinal anastomosis. The new method with the use of biological substances is the local application of platelet-rich plasma. Material and methods. The experimental study included 42 rats, which were divided into two groups. Group 1 – application of unprotected colon anastomosis (n = 21); group 2 – local application of platelet-rich plasma on the colon anastomosis (n = 21). 37 patients were included in the clinical study, who underwent colon anastomosis. The patients were divided into 2 groups: group I (n = 16) had unprotected colon anastomosis and group II (n = 21) - protected anastomosis with platelet-rich plasma. Results. It was experimentally proven that platelet-rich plasma does not aggravate the adhesion process and actually increases significantly the mechanical resistance of colon anastomosis. Microscopical examination demonstrated the acceleration of regenerative processes, in particular, angiogenesis and fibrillogenesis. The clinical study showed significant improvement of the postsurgical results – absence of colon anastomosis dehiscence in cases where local application of platelet-rich plasma was used. Conclusions. A statistically significant increase in dehiscence pressure of the anastomosis at 3rd, 7th and 8th day after surgery was noticed in group 2 vs. group 1. Using platelet-rich plasma does not influence significantly the process of abdominal adhesion, leads to increased regeneration process in the anastomosis area, especially neogenesis and fibrillogenesis (p < 0.5). Using platelet-rich plasma significantly improves the post-surgical results.