Effect of Ischemia/Reperfusion as a Systemic Phenomenon on Anastomotic Healing in the Left Colon

Intestinal ischemia/reperfusion provokes a local inflammatory response leading to a systemic inflammatory state. In this study we aimed to assess the effects of intestinal ischemia/reperfusion injury on anastomotic healing in the left colon with an intact vascular supply. A total of 94 Wistar albino...

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Bibliographic Details
Published in:World journal of surgery 2000-08, Vol.24 (8), p.990-994
Main Authors: Kuzu, Mehmet Ayhan, Tanık, Adil, Kale, İIlhami Taner, Aşlar, Ahmet Keşşaf, Köksoy, Cüneyt, Terzi, Cem
Format: Article
Language:English
Subjects:
Allopurinol - therapeutic use
Anastomosis, Surgical
Animals
Biological and medical sciences
Colon - blood supply
Colon - physiopathology
Colon - surgery
Colonic Diseases - etiology
Colonic Diseases - physiopathology
Colonic Diseases - prevention & control
Female
Free Radical Scavengers - therapeutic use
Medical sciences
Postoperative Complications
Rats
Rats, Wistar
Reperfusion Injury - complications
Reperfusion Injury - physiopathology
Stomach, duodenum, intestine, rectum, anus
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Tissue Adhesions
Wound Healing
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Summary:Intestinal ischemia/reperfusion provokes a local inflammatory response leading to a systemic inflammatory state. In this study we aimed to assess the effects of intestinal ischemia/reperfusion injury on anastomotic healing in the left colon with an intact vascular supply. A total of 94 Wistar albino rats were divided into three groups: sham‐operated control (group I, n= 25), 30 minutes of intestinal ischemia/reperfusion (group II, n= 40), and 7‐day allopurinol pretreatment and intestinal ischemia/reperfusion (group III, n= 29). After the reperfusion experiment, a segmental left colon resection and anastomosis were done. On postoperative days 3 and 7 anastomotic bursting pressure, anastomotic and operative complications, and intraabdominal adhesions were assessed. Mortality rates were 1/25, 16/40, and 4/29 for groups I, II, and III, respectively (p= 0.001). There was no difference among the groups for wound and anastomotic healing parameters evaluated by macroscopic criteria. On postoperative day 7 the mean bursting pressures were 220.3 ± 18.5, 162.0 ± 21.0, and 213.9 ± 24.7 for groups I, II, and II, respectively (p= 0.000). Significantly dense adhesions were found in group II (p= 0.000). Allopurinol pretreatment prevented the effects of ischemia/reperfusion on anastomotic healing of the left colon. Intestinal/ischemia reperfusion causes impairment of anastomotic healing of the left colon. In addition to remote organ effects, reperfusion injury may affect anastomotic healing in the viscera with an intact vascular supply.
ISSN:0364-2313
1432-2323
DOI:10.1007/s002680010170