Effect of local and remote ischemia-reperfusion injury on healing of colonic anastomoses

Kologlu, Murat; Yorganci, Kaya; Renda, Nurten; Sayek, İskender

doi:10.1067/msy.2000.107414

Cited by 92 publications

(73 citation statements)

References 23 publications

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“…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. In a preceding comprehensive study, we have demonstrated a profound negative effect of transient mesenteric ischemia on the development of anastomotic strength from 3 days after operation onwards.…”

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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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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“…The wound healing process is fast in optimally perfused tissue, and sufficient oxygen should reach the wound for proper healing. Related to this issue, Kologlu et al [19] investigated and compared the effects of local IRI and remote IRI on the healing of colonic anastomoses. They concluded that segmental small intestinal, unilateral lower extremity, and unilateral renal IR significantly delay anastomotic healing in the right colon.…”

Section: Discussionmentioning

confidence: 99%

“…The pressure at which the reading suddenly declined or air bubbles were observed was recorded as BP, as previously described. [19] The possible upper limit of the apparatus was 300 mmHg. Measurements higher than 300 mmHg were accepted as 300 mmHg.…”

Section: Burst Pressure (Bp)mentioning

confidence: 99%

Melatonin exhibit supportive effects on oxidants and anastomotic healing during intestinal ischemia reperfusion injury

Özkan¹,

Ersoy²,

Özsoy

et al. 2017

Ulus Travma Acil Cerrahi Derg

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“…In an experimental work, when animals with occlusion of the cranial mesenteric artery on its own were compared with another group with concomitant occlusion of collateral vessels, it failed to find any statistically significant difference in cicatrization 19 . Various models of intestinal ischemia, with mortality rates varying from 8 to 80%, have been used to perform occlusions of the cranial mesenteric artery for periods from 1 to 90 minutes 11,12,[19][20][21][22][23][24][25][26][27] . With regard to the vascular occlusion technique used in this work, a pilot study was initially carried out with 11 animals.…”

Section: Discussionmentioning

confidence: 99%

The influence of methylene blue on the healing of intestinal anastomoses subjected to ischemia and reperfusion in rats

et al. 2010

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PURPOSE: To investigate the influence of methylene blue, on the healing of intestinal anastomoses subjected to ischemia and reperfusion in rats. METHODS: Forty-five rats divided into the following three groups were used: control (G1); ischemia without methylene blue (G2); and ischemia with methylene blue (G3). A laparotomy was performed and the cranial mesenteric artery isolated. Whereas the cranial artery was temporarily occluded for 45 minutes in groups G2 and G3, prior to enterotomy and intestinal anastomosis, in group G1 the enterotomy and intestinal anastomosis were performed without prior lesion. Afterwards, 2mL of 0.5% methylene blue were instilled in the peritoneal cavities of the animals in group G3, and 2mL of isotonic saline solution in the peritoneal cavities of the animals in group G2. After the reperfusion, an enterectomy and intestinal anastomosis were performed. After the animals had been sacrificed on the seventh day after the operation, the abdominal cavity was examined by resection of a segment of the intestine containing the anastomosis in order to measure its strength and for histopathological examination. RESULTS: Free fluid or abscesses in the peritoneal cavity were rare. When inflammation was analyzed, the group subjected to ischemia without methylene blue had a higher score for mononuclear cells (p=0.021) and granulation tissue (p=0.044). No significant difference was observed in the density of type I or type III collagens. CONCLUSION: The methylene blue did not show beneficial effect on the healing of intestinal anastomoses subjected to ischemia and reperfusion in rats.

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Effect of local and remote ischemia-reperfusion injury on healing of colonic anastomoses

Cited by 92 publications

References 23 publications

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

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

Melatonin exhibit supportive effects on oxidants and anastomotic healing during intestinal ischemia reperfusion injury

The influence of methylene blue on the healing of intestinal anastomoses subjected to ischemia and reperfusion in rats

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