Reperfusion injury delays healing of intestinal anastomosis in a rat

Kuzu, Mehmet Ayhan; Köksoy, Cüneyt; Kale, İlhami Taner; Tanik, Adil; Terzi, Cem; Elhan, Atilla Halil

doi:10.1016/s0002-9610(98)00198-6

Cited by 39 publications

(49 citation statements)

References 15 publications

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“…The outcomes of intestinal anastomoses are influenced by numerous parameters including surgical technique, anastomotic tension, blood flow, oxygenation and the existence of any additional systemic diseases that can upset wound healing or worsen ischemia-reperfusion injuries [1,2] . Anastomotic leaks are the primary cause of mortality and morbidity in this postoperative patient group.…”

Section: Introductionmentioning

confidence: 99%

Effects of N-Butyl-2-Cyanoacrylate on High-Level Jejunojejunostomy

Ensari

Genç²,

Çakmak³

et al. 2009

Eur Surg Res

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Background: Morbidity and mortality due to anastomotic complications in gastrointestinal surgery remain important problems. The tissue adhesive N-butyl-2-cyanoacrylate (NB2CA) is used in many fields of surgery. This study was designed to assess the effects of NB2CA on high-level jejunojejunostomy. Materials and Methods: Forty male albino Wistar rats were divided into 4 groups of 10 each. The groups were treated as follows: group 1 underwent only a jejunojejunostomy, group 2 underwent jejunojejunostomy followed by NB2CA application around the anastomosis, group 3 underwent jejunojejunostomy after a 60-min ischemia and a 60-min reperfusion, and group 4 underwent jejunojejunostomy after a 60-min ischemia and a 60-min reperfusion followed by NB2CA application around the anastomosis. At postoperative day 7, the subjects in all groups were sacrificed. Intra-abdominal adhesions, anastomotic complications and anastomotic burst pressures (ABP) were recorded. Results: The analysis of all the groups for adhesion scores and ABP showed statistical significance (p < 0.001). Conclusions: The use of NB2CA had positive effects in terms of increasing ABP both with and without the initial ischemia- reperfusion insult. However, it had the adverse effect of significantly increasing the number of intra-abdominal adhesions.

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Section: Introductionmentioning

confidence: 99%

Effects of N-Butyl-2-Cyanoacrylate on High-Level Jejunojejunostomy

Ensari

Genç²,

Çakmak³

et al. 2009

Eur Surg Res

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“…6 Recent preclinical studies have established that the strength of intestinal anastomoses can be compromised if reperfusion after a transient period of ischemia precedes intestinal resection and anastomosis. This effect occurs both in the locally affected area 7,8 but also if the anastomosis is constructed at a distance. 9,10 So far, this phenomenon has been investigated from 3 days after operation onwards, and experiments aimed at preventing this negative effect are mostly conducted at a single time point, often after 6 or 7 days.…”

Section: Introductionmentioning

confidence: 99%

Early Anastomotic Repair in the Rat Intestine is Affected by Transient Preoperative Mesenteric Ischemia

Posma

Bleichrodt

Lomme

et al. 2009

Journal of Gastrointestinal Surgery

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Introduction During bowel surgery, perioperative blood loss and hypotension can lead to transient intestinal ischemia. Recent preclinical studies reveal that the strength of intestinal anastomoses can be compromised after reperfusion. So far, this phenomenon has not been investigated in the very first days of healing when wound strength is lowest. Material and Method Ischemia was induced in rats by clamping both the superior mesenteric artery and ileal branches for 30 min. Immediately after declamping, anastomoses were constructed in both terminal ileum and descending colon. The same was done in control groups after sham-ischemia. Anastomotic bursting pressure and breaking strength were measured immediately after operation (day 0) and after 1, 2, or 3 days. Anastomotic hydroxyproline content, gelatinase activity, and histology were analyzed. Results and Discussion In ileal anastomoses, at day 1, both the breaking strength and bursting pressure were significantly (p<0.05) lower in the ischemic group, while at day 2, this was the case for the bursting pressure only. In the colon, the bursting pressure in the ischemic group was lower at day 1. Anastomotic hydroxyproline content remained unchanged. Increased presence of the various gelatinase activities was found in ileum only at day 0 and in colon at days 1 and 2. Histological mucosal damage was found in ischemia-reperfusion groups. Conclusion Transient mesenteric ischemia can negatively affect anastomotic strength during the very first days of healing, even if the tissue used for anastomotic construction looks vital.

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“…Bu çalışmaların çoğunda anastomoz iyileşmesi anastomoz patlama basıncı, hidroksiprolin düzeyi ve histopatolojik inceleme ile değerlendirilmiştir. [22][23][24][25][26] Genel olarak bu parametrelerin anastomoz iyileşmesini objektif olarak değerlendirdi-ği yönünde literatürde geniş bir görüş birliği vardır. Bu nedenle çalışmamızda anastomoz iyileşmesini bu parametrelerle değerlendirdik.…”

Section: Discussionunclassified