Preoperative irradiation with 5 × 5 Gy in a murine isolated colon loop model does not cause anastomotic weakening after colon resection

Karliczek, Anne; Zeebregts, Clark J.; Benaron, David A.; Coppes, Robert P.; Wiggers, Theo; Dam, van Gooitzen

doi:10.1007/s00384-008-0507-z

Cited by 6 publications

(5 citation statements)

References 31 publications

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“…The significant reduction in colon mtDNA content in group 2 ( Figure 4A) when compared with patients in group 3 could be attributable to chemotherapy; however, the reason for the reduction of mtDNA content in group 1 remains unclear. Because radiochemotherapy increases ROS production (28)(29)(30)(31), the results of the present study may lend support to the initial hypothesis that, in patients with dehiscence, there should be a greater development of ROS inside the mitochondria.…”

Section: Discussionsupporting

confidence: 76%

Effects of Reactive Oxygen Species on Mitochondrial Content and Integrity of Human Anastomotic Colorectal Dehiscence: A Preliminary DNA Study

Potenza

Calcabrini

Bellis

et al. 2011

Canadian Journal of Gastroenterology

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Section: Discussionsupporting

confidence: 76%

Effects of Reactive Oxygen Species on Mitochondrial Content and Integrity of Human Anastomotic Colorectal Dehiscence: A Preliminary DNA Study

Potenza

Calcabrini

Bellis

et al. 2011

Canadian Journal of Gastroenterology

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“…Traction forces were gauged using a tensiometer (FL100, Kern & Sohn, Balingen, Germany) until the muscular layer was disrupted and the mucosal layer was still visible. This was registered as a loss of force by the tensiometer and the maximum value was recorded as the breaking force [50][51][52][53][54][55]. The experimental setup has been described in detail elsewhere [53,54] and is photographically depicted in Figure 2.…”

Section: Methodsmentioning

confidence: 99%

Not All Porcine Intestinal Segments Are Equal in Terms of Breaking Force, but None Were Associated to Allometric Parameters

Kratz,

Dauvergne,

Kronberg

et al. 2023

Gastroenterology Insights

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Biomechanics are gaining ground in gastroenterology in the creation of educational models and to describe the necessary forces to perforate hallow organs during endoscopy. We thus investigated the breaking forces of porcine intestinal segments and whether they could be predicted based on body weight or crown–rump length. Based on a priori power-analyses, 10 pigs were included. The breaking forces were determined with a motorized test stand. We found that the breaking forces of intestinal segments were different (H(6) = 33.7, p < 0.0001): Ileal breaking force (x¯ = 24.14 N) was higher than jejunal (x¯ = 14.24 N, p = 0.0082) and colonic (x¯ = 11.33 N, p < 0.0001) breaking force. The latter was also smaller than cecal breaking force (x¯ = 24.6 N, p = 0.0044). Likewise, rectal (x¯ = 23.57 N) breaking force was higher than jejunal (p = 0.0455) and colonic (p = 0.0006) breaking force. Breaking forces were not correlated to body weight or crown–rump length (R < 0.49, p > 0.148). Intestinal segments differ in their breaking forces. The colon had the least resistance to traction forces. It remains to be determined if similar relationships exist in humans in order to validate porcine models for endoscopy and surgery.

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“…El-Malt et al 31 reported that preoperative CRT had no harmful effect on the mechanical strength of colonic anastomosis. Besides the studies defending that RT has negative effects on anastomosis healing, 5,32,33 there are also studies [34][35][36] reporting that RT does not impair wound healing. Various outcomes have been reported in the studies investigating the effects of 5-FU on wound healing.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Hyperbaric Oxygen Therapy on Experimental Colon Anastomosis After Preoperative Chemoradiotherapy

Yıldız¹,

Can²,

Yağcı³

et al. 2013

International Surgery

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The aim of the present study was to investigate the effect of hyperbaric oxygen therapy (HBOT) on colon anastomosis after chemoradiotherapy (CRT). Sixty female WistarAlbino rats were divided into 5 groups and underwent left colon resection and end-toend anastomosis. CRT simulation was performed on 2 sham groups before the anastomosis, and 1 of these groups was administered additional postoperative HBOT. Two groups were administered CRT before the anastomosis, and 1 of them received additional postoperative HBOT. On postoperative day 5, all groups underwent relaparotomy; burst pressure was measured and samples were obtained for histopathologic and biochemical analysis. There was a significant weight loss in the CRT groups and postoperative HBOT had an improving effect. Significantly decreased burst pressure values increased up to the levels of the controls after HBOT. Hydroxyproline levels were elevated in all groups compared to the control group. Hydroxyproline levels decreased with HBOT after CRT. No significant difference was observed between the groups regarding fibrosis formation at the anastomosis site. However, regression was observed in fibrosis in the group receiving HBOT after CRT. Preoperative CRT affected anastomosis and wound healing unfavorably. These unfavorable effects were alleviated by postoperative HBOT. HBOT improved the mechanical and biochemical parameters of colon anastomosis in rats.Key words: Anastomosis -Chemoradiotherapy -Hyperbaric oxygen -Rat -Burst pressure 2 Although adjuvant therapy has been a well-accepted procedure to prevent metastasis and local recurrence after surgical resection, more recently neoadjuvant therapy has gained popularity to enable secondary curative resection with clear surgical margin and to prolong overall and recurrence-free survival.2 It has been reported that local recurrence rate is lower, toxicity is rare, and the anal sphincter is more likely to be preserved in those undergoing preoperative radiation. 1,2Despite the current advances in surgical techniques, anastomotic leakage is a severe complication leading to morbidity and mortality after intestinal surgery.3-6 Chemoradiotherapy (CRT) has the potential to lead to inadequate vascularization in tissues, a well-known risk factor for intestinal anastomosis leak. Impaired oxygenation as a result of hampered vascularization may lead to delay in wound healing, which ultimately impairs anastomotic durability. Studies on factors that enhance wound healing to prevent anastomotic leakage in colon anastomosis have been accelerated in the past decade. In a limited number of studies performed for this purpose, hyperbaric oxygen therapy (HBOT), which is applied by means of intermittent inhalation of 100% oxygen under 1 atmosphere pressure, has been reported to have favorable effects on intestinal anastomotic healing.7-9 However, whether HBOT can reverse potential side effects of CRT on would healing and anastomotic durability is unclear. The aim of the present study was to investigate the effects of HBOT on the bioche...

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Preoperative irradiation with 5 × 5 Gy in a murine isolated colon loop model does not cause anastomotic weakening after colon resection

Cited by 6 publications

References 31 publications

Effects of Reactive Oxygen Species on Mitochondrial Content and Integrity of Human Anastomotic Colorectal Dehiscence: A Preliminary DNA Study

Effects of Reactive Oxygen Species on Mitochondrial Content and Integrity of Human Anastomotic Colorectal Dehiscence: A Preliminary DNA Study

Not All Porcine Intestinal Segments Are Equal in Terms of Breaking Force, but None Were Associated to Allometric Parameters

The Effects of Hyperbaric Oxygen Therapy on Experimental Colon Anastomosis After Preoperative Chemoradiotherapy

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