Does the application of Ankaferd Blood Stopper rectally have positive effects on the healing of colorectal anastomosis and prevention of anastomotic leakage? An experimental study (original) (raw)
Related papers
Topical application of Ankaferd Blood Stopper® modifies the healing of colon anastomosis in rats
Surgical Techniques Development, 2011
Ankaferd Blood Stopper ® (ABS) offered as a hemostatic agent is a standardized herbal extract obtained from five different plants. The effects of ABS on colonic anastomosis are unknown. This study was designed to assess potential effects on the anastomosis of left colon in an experimental animal model. Thirtytwo male Wistar albino rats were randomized into two groups and subjected to colon anastomosis. The study group subjected to colon anastomosis with topical application of ABS to control of mucosal bleeding at the cut ends of the colon, and the control group subjected to colon anastomosis only. The rats were killed 3 and 7 days postoperatively. Four types of assessment were performed: bursting pressure, bursting wall tension, histopathology, and biochemical analysis. Compared to the control group, ABS used rats displayed a higher bursting pressure (P<0.05) and anastomotic hydroxyproline content (P<0.05). The use of ABS leads to a significant decrease in malondealdehyde levels (P<0.05) and increase in paraoxonase activity (P<0.05) at both time points. Histopathological analysis revealed that the use of ABS improves anastomotic healing in terms of reepithelialization, increased neovascularization, diminished ischemic necrosis, and inflammatory infiltration to muscle layer. Topical application of ABS to control of mucosal bleeding at the cut ends of the colon significantly improve the anastomotic wound healing by means of increasing mechanical strength and amount of tissue HPL level.
Şişli Etfal Hastanesi tıp bülteni, 2019
C olorectal cancer is the fourth most common cause of cancer deaths worldwide, [1] and the anastomosis leakage is one of the most important complications of colorectal surgery. Despite the recent advances in surgical techniques and technologic devices, the anastomosis leakage occurs in up to 37% of patients with colorectal cancer. [2] The main risk factors of leakage include patient-related factors, such as severe anemia, diabetes mellitus, immunosuppression, history of radiation therapy, sepsis, malnutrition, hypoalbuminemia, and hypovolemia, as well as issues with the surgical techniques including excessive suture tension, inadequate perfusion of the anastomosis edges, distal lu-Objectives: Ankaferd BloodStopper (ABS) is a topical hemostatic agent that modulates the inflammatory response and accelerates wound healing. The aim of this study was to determine the effects of ABS on the colon anastomosis wound healing in a rat model. Methods: Thirty-two Wistar albino rats were divided into four groups as follows: Group A (n=8), left colonic anastomosis plus ABS treatment (sacrificed on the 3 rd day); Group B (n=8) (control), left colonic anastomosis (sacrificed on the 3 rd day); Group C (n=8), left colonic anastomosis plus ABS treatment (sacrificed on the 7 th day); and Group D (n=8) (control), left colonic anastomosis (sacrificed on the 7 th day). All rats were sacrificed at the end of the experiment to assess the anastomosis integrity and the presence of perianastomosis abscesses, peritonitis, and adhesions. Additionally, the bursting pressure and hydroxyproline (OH-pyroline) levels were determined, and a histopathologic evaluation of the perianastomosis tissue was conducted. Results: The mean bursting pressure on Day 7 was significantly higher than that on Day 3 in the ABS group (p=0.017). Overall, the bursting pressure was higher in animals treated with ABS than in the control animals, although the difference was not statistically significant. The OH-pyroline levels of both ABS groups were significantly higher than in the control groups. The mean OH-pyroline level on Day 7 was higher than that on Day 3 in the ABS-treated animals (p=0.038). Conclusion: ABS increases collagen formation and neovascularization, and it has a positive impact during the colon anastomosis healing in an experimental model of wound healing.
Effects of Ankaferd on Anastomotic Healing of Colon
Journal of Investigative Surgery, 2014
Background: Ankaferd (Ankaferd blood stopper R , ABS) is a recently developed topical hemostatic agent. ABS is a standardized mixture of the plants Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum, and Urtica dioica. Through its effects on the endothelium, blood cells, angiogenesis, cellular proliferation, vascular dynamics, and cell mediators; Ankaferd plays a part in inflammation and hemostasis processes. The aim of this experimental study is to assess the effects of ABS on the left colonic anastomoses under normal, septic, and ischemic conditions. Methods: Forty-eight Wistar Albino male rats were divided into six weight-matched equal groups: A, anastomosis in normal condition (n = 8); AA, anastomosis with ABS in normal condition (n = 8); AS, anastomosis in septic condition (n = 8); AAS, anastomosis with ABS in septic condition (n = 8); AI, anastomosis in ischemic condition (n = 8); and AAI, anastomosis with ABS in ischemic condition (n = 8). Blood and tissue samples were taken for the histopathological and biochemical studies after the anastomotic bursting pressures were measured. Results: Higher hydroxyproline levels (p = .048) and angiogenesis (p = .038) were observed in the sepsis-induced rats compared to the control group. The inflammatory activity, fibrosis, and granulation were comparable in all experimental groups. Ankaferd improved the angiogenesis under septic conditions (AAS) when compared to the control group (AI; p = .038). Conclusions: ABS may support anastomotic healing in septic conditions. Topical ABS application controlling the mucosal bleeding at the cut ends of the colon may also improve the anastomotic wound healing by means of increasing mechanical strength and positively affecting angiogenesis. Further studies shall focus on the clinical importance of those findings.
Effect of persistently elevated intraabdominal pressure on healing of colonic anastomoses
The American Journal of Surgery, 1999
BACKGROUND: The adverse effects of elevated intraabdominal pressure (IAP) on abdominal organs are realized, but its influence on anastomotic healing has not been studied. The aim of this study was to evaluate the effect of elevated IAP on healing of colonic anastomoses. METHODS: Thirty rats, which all had right colonic anastomoses, were divided into five groups. Group 1 was the control group, and group 2 had fecal peritonitis. IAP was maintained between 4 to 6 mm Hg in group 3, 8 to 12 mm Hg in group 4, and 14 to 18 mm Hg in group 5 until all rats were sacrificed on day 4. Bursting pressures and tissue hydroxyproline concentrations of anastomoses were then analyzed and compared. RESULTS: Mean ؎ SEM of bursting pressures were 143 ؎ 2.9 mm Hg in group 1, 72 ؎ 14.4 mm Hg in group 2, 77.3 ؎ 7.9 mm Hg in group 3, 57.5 ؎ 11.2 mm Hg in group 4, and 40.1 ؎ 9.6 mm Hg in group 5 (P <0.0001, one-way analysis of variance [ANOVA]). Mean ؎ SEM of tissue hydroxyproline concentrations were 5.3 ؎ 0.3 g/mg in group 1, 4.7 ؎ 0.5 g/mg in group 2, 4.6 ؎ 0.6 g/mg in group 3, 3.6 ؎ 0.5 g/mg in group 4, and 2.4 ؎ 0.2 g/mg in group 5 (P ؍ 0.0026, one-way ANOVA). The bursting pressure and hydroxyproline concentrations had good correlation (P <0.001, r ؍ 0.76). CONCLUSIONS: Elevated IAP delays healing of colonic anastomoses and 4 to 6 mm Hg IAP delays healing as much as fecal peritonitis. More elevated IAP delays healing more than fecal peritonitis. These events may be clinically important and may result from local-systemic effects of IAP.
Meandros Medical and Dental Journal, 2018
Amaç: Kolon anastomozu ile ilgili kaçak nedenleri konusunda devam etmekte olan araştırmalar vardır. Bu çalışmada anastomoz dayanıklılığının ameliyat öncesinde beta-hidroksi-metil bütirat (HMB) ile artıp artmayacağı denetlenmiştir. Gereç ve Yöntemler: Kırk rat 4 gruba randomize edildi. Grup A (n=10) ratları standart rat yemi ile birlikte arjinin+glutamin+HMB'den zengin diyetle 7 gün beslendikten Öz Objective: The studies on anastomotic leakage which is one of the leading serious complications of colonic anastomoses keep going as well as other surgical researches. This study was designed to investigate effects of hydroxy-ß-methyl butyrate (HMB) on anastomotic healing. Materials and Methods: Forty rats were randomized into four groups. Group A (n=10) rats received chow food plus arginine+glutamine+HMB rich diet for 7 days before right colonic transection followed by an end-to-end anastomosis. Group B (n=10) rats received chow food plus arginine and glutamine rich diet for 7 days before the same surgical procedure. Group C (n=10) rats underwent the same procedure after a 7-day chow plus glutamin rich diet. Group D (n=10) rats had the surgery after a chow food only diet for seven days. All the subjects were fed accordingly to their groups for 7 days postoperatively. On the 7 th day, all rats were sacrificed under anesthesia to measure anastomotic bursting pressure and evaluate hydroxyproline levels as well as histopathological scoring of anastomotic line. Results: This study revealed significantly increased hydoxyproline level at the 7 th day in group A (p<0.002) and group B (p<0.001) relative to group D. There were no significant differences among the groups for anastomotic bursting pressures and histopathological scores. Conclusion: Enteral HMB support may result statistically significant increased biochemical anastomotic strength with an insignificant difference in biomechanical force. Although more studies are needed to delineate better efficacy, preoperative enteral HMB support may decrease postoperative morbidity and mortality.
Different Surgical Methods in Colon Anastomosis: Experimental Study
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
- BACKGROUND: Although many methods have been defined for colonic anastomosis, anastomotic leak still remains important for sepsis control and successful healing. AIM: The purpose of this study was to compare the effects of conventional suture, polyglactin 910 mesh, and omental flap coverage on healing and anastomotic leak in experimental colonic anastomosis in rats. METHOD: This study was conducted on 18 Wistar rats and the animals were divided into three groups as follows: Group 1: primary suture group; Group 2: primary suture plus polyglactin 910 mesh group; and Group 3: primary suture plus omental flap coverage group. Groups were compared in terms of anastomotic bursting pressure, inflammation, fibroblastic activity, neovascularization, and collagen amount. RESULTS: There was a statistically significant difference in anastomotic bursting pressure between Groups 1 and 2 and between Groups 1 and 3 (p=0.004, p<0.05). There was a significant difference in fibroblastic activity be...
Effect of n-Butyl-2-Cyanoacrylate on High-Risk Colonic Anastomoses
The Kaohsiung Journal of Medical Sciences, 2009
Colonic anastomosis is one of the most frequent operations in surgical practice. The success rates of anastomoses are highly dependent on the surgical technique. The surgeon's experience, medical and nutritional status of the patient, interval and tightness of the sutures, suture material and technique, can effect anastomotic healing . Despite the evidence for technical improvements in colonic anastomosis, these operations continue to show significant morbidity compared with either anastomotic dehiscence or associated medical conditions. One of the most common debilitating conditions is peritonitis, which is a well-documented source of anastomotic breaks. This type of condition is commonly observed in patients undergoing surgery because of a complicated ileus or peritonitis. Most surgeons prefer to perform a stoma rather than anastomoses in a septic abdomen.
Prevention of leakage by sealing colon anastomosis: experimental study in a mouse model
Journal of Surgical Research, 2013
In colorectal surgery, anastomotic leakage (AL) is the most significant complication. Sealants applied around the colon anastomosis may help prevent AL by giving the anastomosis time to heal by mechanically supporting the anastomosis and preventing bacteria leaking into the peritoneal cavity. The aim of this study is to compare commercially available sealants on their efficacy of preventing leakage in a validated mouse model for AL. Six sealants (Evicel, Omnex, VascuSeal, PleuraSeal, BioGlue, and Colle Chirurgicale Cardial) were applied around an anastomosis constructed with five interrupted sutures in mice, and compared with a control group without sealant. Outcome measures were AL, anastomotic bursting pressure, and death. In the control group there was a 40% death rate with a 50% rate of AL. None of the sealants were able to diminish the rate of AL. Furthermore, use of the majority of sealants resulted in failure to thrive, increased rates of ileus, and higher mortality rates. If sealing of a colorectal anastomosis could achieve a reduction of incidence of clinical AL, this would be a promising tool for prevention of leakage in colorectal surgery. In this study, we found no evidence that sealants reduce leakage rates in a mouse model for AL. However, the negative results of this study make us emphasize the need of systemic research, investigating histologic tissue reaction of the bowel to different sealants, the capacity of sealants to form a watertight barrier, their time of degradation, and finally their results in large animal models for AL.