Comparison of three different application routes of butyrate to improve colonic anastomotic strength in rats (original) (raw)
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The effect of polyethylene glycol and butyrate on anastomotic healing in the rat colon
Techniques in Coloproctology, 2006
Background The use of mechanical bowel preparation is much debated. Methods We evaluated the effects of polyethylene glycol (PEG), with or without a single dose of 3.0 mmol butyrate (BUT), on the bursting pressure (BP) of an intact colon segment and a colon anastomosis in rats. Also, histopathologic damage was studied. Results In rats without colectomy, the mean BP was 159.2 mmHg (SD=18.9) after PEG treatment and 116.7 mmHg (SD=27.5) in controls (p=0.001). In rats with colectomy, the mean BP was 90.4 mmHg (SD=45.9) in the PEG group, 108.0 mmHg (SD=31.9) in the BUT group, and 102.7 mmHg (SD=44.7) in controls (p=0.44). No significant differences in histopathologic scores were observed between rats treated with PEG and controls. Conclusions PEG does not interfere with anastomotic healing in rats as measured by BP. No benefit of a single dose of butyrate was observed.
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.
2-Octylcyanoacrylate for the prevention of anastomotic leak
The Journal of surgical research, 2018
Anastomotic leak after colorectal surgery is a significant cause of morbidity and mortality. The aim of this study was to evaluate the impact of a reinforced colo-colonic anastomosis with tissue adhesive, 2-octylcyanoacrylate (2-OCA), on the integrity of anastomotic healing as measured by anastomotic bursting pressure. Sixty-eight female Sprague-Dawley rats underwent a rectosigmoid colon transection and a sutured end-to-end anastomosis followed by randomization to receive no further intervention or reinforcement with the tissue adhesive, 2-OCA. After seven postoperative days, a macroscopic assessment of the anastomosis, mechanical assessment to determine anastomotic bursting pressure, and a detailed semi-quantitative histopathologic healing assessment were performed. Thirty-four animals were randomized to each group. Study characteristics did not differ between the groups. There was also no difference in the degree of adhesions present postoperatively. Although there was no differen...
Effects of a Glutamine Enema on Anastomotic Healing in an Animal Colon Anastomosis Model
Annals of Coloproctology, 2015
Purpose: Anastomotic leakage in colorectal surgery is a very important issue. Although many studies have shown the positive effects of enteral glutamine (Gln) on anastomotic healing, none has assessed the effects of administering Gln via an enema for anastomotic healing. To fill this study gap, this study investigated the intraluminal effect of administration of Gln enema on the healing of colonic anastomosis in a rat model. Methods: Thirty Wistar albino rats were divided into three groups containing 10 rats each and were subjected to distal left colon transection and anastomosis. Postoperatively, group I (the control group) was administered no treatment, group II was administered daily placebo enemas containing physiological saline, and group III was administered daily 2% L-Gln enemas. After sacrifice on postoperative day 5, anastomotic healing, burst pressure, tissue hydroxyproline levels, and histological parameters were measured, and group values were compared via statistical analysis. Results: Group III was found to have the highest mean bursting pressure and tissue hydroxyproline levels and the lowest mean ischemia score. While the values of these parameters were not found to differ significantly among the groups, the lack of significance may have been due to the limited number of subjects examined. Conclusion: Administration of a Gln enema may have a positive effect on anastomosis in terms of bursting pressure and histopathological parameters. Future research should examine administration of a preoperative Gln enema as a means of decreasing the traumatic effects of the enema and identifying its applicability in surgical practice.
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.
Colorectal Anastomotic Leakage: A New Experimental Model
Journal of Surgical Research, 2009
Anastomotic leakage is the major complication after colorectal surgery. To date, animal experiments concerning colorectal anastomosis focus on anastomotic healing instead of anastomotic leakage. This study aims to develop a new experimental model for colorectal anastomotic leakage. A control group, receiving an anastomosis with 12 interrupted sutures, was compared to a group receiving an anastomosis with 6 interrupted sutures. When the leakage rate was observed to be too low, the number of sutures was decreased stepwise, to 5 or less. Each group contained 9 "C57Bl6-mice". After 7 d the Anastomotic Bursting Pressure (ABP) was determined. In the first experiment, one mouse (11.1%) in the case group and none in the control group developed leakage. Average ABP was 152.2 mmHg in the control group and 138,8 mmHg in the case group (P=0.111). In the second experiment, case group receiving an anastomosis with 5 sutures, 4 mice (44.4%) in the case group developed leakage. This experiment was repeated twice resulting in leakage rates of 33.3% and 44.4%. The average overall ABP in the case group was 142.7 mmHg vs. 179.9 mmHg (P=0.022) in the control group. The mice without leakage showed a stabilization of average weight loss around day 2 and 3 and a decrease afterwards. The mice with leakage showed a decrease only after day 5. The difference in wellness-scores between the groups with- and without leakage was 2 points, increasing during follow-up. The model of anastomotic leakage caused by creating an anastomosis with 5 interrupted sutures is feasible. Weight loss and wellness-scores are good predictors of leakage.
Colorectal Anastomotic Leakage: A new, Validated Rat Model
Anastomotic leakage (AL) remains an important complication after colorectal surgery. Experimental research aims to find a solution to overcome this serious complication; however, no validated AL model exists in the rat. This study was designed to develop a feasible new, reproducible AL model for use in colorectal anastomotic research.
British Journal of Surgery, 1995
The influence of intraoperative lavage with various solutions was tested on the healing of experimental colonic anastomoses performed in the presence of obstruction. After 24 h of ligature obstruction to the pelvic colon, male Wistar rats (n = 108) underwent colonic resection and primary anastomosis, using lavage with one of four different fluids: saline, povidone-iodine, 10 per cent hypertonic glucose and short-chain fatty acids (SCFA). Controls had no lavage. The anastomotic segment was excised and studied after 3 or 6 days. At day 3, mean(s.d.) bursting pressure was significantly greater in animals receiving SCFA compared with controls (81.2(23.0) mmHg versus 34*8(34*0) mmHg). Mean(s.d.) bowel wall tension was higher in rats with SCFA (30.6(8.1) N/m X or hypertonic glucose (29.5(10.1) N/m X l t 4 ) compared with controls (12.2(12.1) N/ m X lo4). By day 6, the anastomosis was more resistant to intraluminal pressure in each lavage group; mean(s.d.) hydroxyproline concentration at the anastomosis was greater in rats with SCFA (12-4(15) pg/mg) or hypertonic glucose (11.6(2.9) pg/mg) than in controls (8-9(1-5) pgJ mg). Anastomotic healing is improved by all types of intraoperative colonic lavage, particularly with SCFA and hypertonic glucose solutions.