Does sildenafil reverse the adverse effects of ischemia on ischemic colon anastomosis: Yes, ‘no’

İrkörücü, Oktay; Uçan, Bülent Hamdi; Çakmak, Güldeniz Karadeniz; Emre, Arif; Taşçılar, Öge; Ofluoglu, Ebru; Bahadir, Burak; Karakaya, Kemal; Demirtaş, Canan; Ankaralı, Handan; Kertiş, Gürkan; Paşaoğlu, Hatîce; Comert, Mustafa

doi:10.1016/j.ijsu.2008.10.003

Cited by 21 publications

(31 citation statements)

References 28 publications

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“…A dose of 10 mg/kg sildenafil achieves possible systemic protective effects in rats. Higher doses (over 20 mg/kg) may have greater vasodilatatory effects but they may also have side effects such as hypotension, diminished tissue perfusion, and excessive anti-inflammatory response, whereas doses lower than 10 mg/kg is less or not effective at all [23,24]. For this reason, we chose to administer sildenafil as a single daily dose of 10 mg/kg.…”

Section: Discussionmentioning

confidence: 99%

Effect of sildenafil on wound healing: an experimental study

Derıcı¹,

Kamer²,

Ünalp³

et al. 2009

Langenbecks Arch Surg

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Section: Discussionmentioning

confidence: 99%

Effect of sildenafil on wound healing: an experimental study

Derıcı¹,

Kamer²,

Ünalp³

et al. 2009

Langenbecks Arch Surg

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“…In groups 1, 2 and 3, a colon segment of 1-, 2-and 3-cm long, respectively, underwent selective devascularization, as previously described by Griffen24. This method consists of devascularization of the marginal artery at two points, as well as the vasa recti located in-between, using a bipolar cautery 1 . At the midpoint of the devascularized segment, the colon was sectioned and an anastomosis was performed in the same way as described in control group.…”

Section: Anesthesia and Surgical Proceduresmentioning

confidence: 99%

“…Surgeries that require anastomosis of the large bowel are among the most commonly performed abdominal procedures in the western world 1 . Ongoing advances in terms of perioperative care and surgical techniques have provided better results in the surgical treatment of patients with colorectal diseases.…”

Section: ■ Introductionmentioning

confidence: 99%

“…There is a general consensus on the key role of blood supply, mainly at the bowel margins, for the proper healing of intestinal anastomosis. Therefore, a rigorous intraoperative evaluation of the intestinal perfusion is essential for the prevention of anastomotic dehiscence 1,6 . Clinical tests to predict the occurrence of anastomotic dehiscence have very low accuracy, with a failure rate up to 60% 4,[7][8][9] .…”

Section: ■ Introductionmentioning

confidence: 99%

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Fluorescent test accurately predicts leak of ischemic colon anastomosis in rats

et al. 2017

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Methods: This experimental controlled trial randomly assigned 55 rats to four groups. Anastomoses were performed in non-ischemic colon segments (control group) and in ischemic colon segments measuring 1, 2 or 3 cm long (groups 1, 2 and 3, respectively). Fluorescein was injected and the tissues were examined under ultraviolet light. Seven days later, a second-look surgery was performed to check for the presence or absence of anastomosis dehiscence. Results: Twenty-four rats presented anastomotic dehiscence during the second-look surgery. Reticular and nonfluorescent patterns were significantly associated with the occurrence of anastomotic dehiscence. Fluorescein fluorescence had a sensitivity of 95.8%, specificity of 89.2%, positive predictive value of 88.4%, negative predictive value of 96.2%, and accuracy of 92.3% to predict anastomotic dehiscence. Conclusion: Fluorescein fluorescent test can accurately predict leak in a model of ischemic colonic anastomosis in rats.

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“…Recent laboratory studies demonstrated successful effects of PDE V inhibitors on cardioprotection after ischemia reperfusion injury [4,5] , as well as in ischemic injury of other organs, such as the colon, liver, and brain [6,7] . Deibert et al 8] revealed that vardenafil had increased portal flow and lowered portal pressure in patients with cirrhotic livers.…”

Section: Introductionmentioning

confidence: 99%

Mitigation of indomethacin-induced gastric mucosal lesions by a potent specific type V phosphodiesterase inhibitor

Karakaya¹,

Hancı²,

Bektaş³

et al. 2009

WJG

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AIM:To investigate the gastroprotective effect of vardenafil against indomethacin-induced gastric damage. METHODS:Forty-eight female Wistar albino rats were randomly divided into 6 groups. Group 1 received saline only. Group 2 (indomethacin) received indomethacin. Rats in group 3 and 4 were pretreated with different doses of famotidine. Group 5 and 6 were pretreated with different doses of vardenafil. Rats in groups 3 to 6 received 25 mg/kg indomethacin 30 min after pretreatment. The animals were sacrificed 6 h later and their stomachs were opened. Gastric lesions were counted and measured. The stomach of each animal was divided in two parts for histopathological examinations and nitric oxide (NO) and malondialdehyde (MDA) assays, respectively. RESULTS:There were no gastric mucosal lesion in the saline group but all rats in the indomethacin group had gastric mucosal ulcerations (ulcer count; 6.25 ± 3.49, and mean ulcer area; 21.00 ± 12.35). Ulcer counts were diminished with famotidine 5 mg/kg (4.12 ± 2.47, P > 0.05), 20 mg/kg (2.37 ± 4.43, P < 0.05), vardenafil 2 mg/kg (4.37 ± 3.06), and vardenafil 10 mg/kg (1.25 ± 1.38, P < 0.05) compared to the indomethacin group.Gastric mucosal lesion areas were diminished with famotidine 5 mg/kg (8.62 ± 2.97, P < 0.001), famotidine 20 mg/kg (0.94 ± 2.06, P < 0.001), vardenafil 2 mg/kg (6.62 ± 5.87, P < 0.001), and vardenafil 10 mg/kg (0.75 ± 0.88, P < 0.001) compared to the indomethacin group. MDA levels were significantly higher in indomethacin group (28.48 ± 14.51), compared to the famotidine 5 mg/kg (6,21 ± 1.88, P < 0.05), famotidine 20 mg/kg (5.88 ± 1.60. P < 0.05), vardenafil 2 mg/kg (15.87 ± 3.93, P < 0.05), and vardenafil 10 mg/kg (10.97 ± 4.50, P < 0.05). NO concentration in gastric tissues of the famotidine groups were significantly increased (P < 0.05), but the NO increases in the vardenafil groups were not statistically significant. Histopathology revealed diminished gastric damage for pretreatment groups compared to the indomethacin group (P < 0.05). CONCLUSION:Vardenafil affords a significant dosedependent protection against indomethacin induced gastric mucosal lesions in rats.

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Does sildenafil reverse the adverse effects of ischemia on ischemic colon anastomosis: Yes, ‘no’

Abstract: Our results showed that 10mg/kg sildenafil decreased the adverse effects of ischemia on the healing of ischemic left colon anastomosis. Additional investigations are needed to confirm the effects of phosphodiesterase-5 inhibitors in ischemic colon anastomosis models.

Cited by 21 publications

References 28 publications

Effect of sildenafil on wound healing: an experimental study

Effect of sildenafil on wound healing: an experimental study

Fluorescent test accurately predicts leak of ischemic colon anastomosis in rats

Mitigation of indomethacin-induced gastric mucosal lesions by a potent specific type V phosphodiesterase inhibitor

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