Effect of major small bowel resection on dimethylhydrazine‐induced bowel carcinogenesis

Harte, Paul J.; Steele, Glenn; Rayner, Anthony A.; Munroe, Alelia E.; King, Vincent; Wilson, Richard E.

doi:10.1002/jso.2930180113

Cited by 8 publications

(2 citation statements)

References 21 publications

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“…A healing anastomotic wound produces colonic crypt cell hyperproliferation, which seems to be the crucial determinant for malignant change in the epithelium. Factors which en hance CCPR also enhance tumour yield [17][18][19] and vice versa [6, 20. 21 ].…”

Section: Discussionmentioning

confidence: 99%

The Influence of the Interaction of Sutures with the Mucosa on Tumour Formation at Colonic Anastomoses in Rats

Hubens

Totté²,

Verhulst³

et al. 1993

Eur Surg Res

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In order to explore the respective role of wound healing and suture material on metachronous carcinogenesis at colonic lines in rats, tumour yield was studied after the administration of a chemical carcinogen (azoxymethane) at the moment that in one group of rats most of the suture material was still present and crypt cell proliferation elevated, while in another group, no more suture material was present and crypt cell proliferation rate (CCPR) normalized at the anastomotic site. Azoxymethane (15 mg/kg/week, s.c, during 6 weeks) was administered in male Sprague-Dawley rats (n = 105) 8 weeks after the creation of an anastomosis in the ascending and descending colon with either stainless steel sutures (group A, n = 30) or fast-absorption Vicryl (Vicryl Rapide®, group B, n = 30). A control group (group C, n = 30) underwent a sham laparotomy before the administration of azoxymethane, while the animals of a fourth group (group D, n = 15) were not operated upon and received no azoxymethane. Twenty-six weeks after the first injection of azoxymethane there was no significant difference in the total colo-rectal tumour yield in the three operated groups (A, B, C), but a significantly greater proportion of anastomotic tumours (28/68 vs. 13/88, p < 0.01)and more anastomotic tumours per rat (28/23 vs. 13/28, p = 0.01) as well as more rats with anastomotic tumours (16/23 vs. 11/28, p = 0.04) were found in the steel-sutured group (A), compared with the control group (C). No significant differences were observed in tumour distribution between the groups in which the anastomoses were carried out with Vicryl Rapide (B) and the control group (C). Thirty-six weeks after operation steel sutures were recovered in 30.4% (7/23) of the left-sided anastomoses and in only 8.7% (2/23) of the right-sided anastomoses. At that time, CCPR was significantly elevated in the left-sided anastomoses only, while the CCPR in the right-sided anastomoses was normal when compared with all the other groups (A, B, C and D). The present study showed a shift in the distribution of tumours towards the anastomotic sites at which suture material was present and the CCPR raised, at the moment of carcinogen administration, confirming the importance of the interaction of sutures with the mucosa in tumour formation. The actual elimination process of the suture material might influence the CCPR and act as a cocarcinogenic factor. In view of these observations, either the use of strictly inert suture material or the development of sutureless anastomotic techniques should be encouraged in the construction of colonic anastomoses.

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Section: Discussionmentioning

confidence: 99%

The Influence of the Interaction of Sutures with the Mucosa on Tumour Formation at Colonic Anastomoses in Rats

Hubens

Totté²,

Verhulst³

et al. 1993

Eur Surg Res

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“…Under experimental conditions, hyperplasia follows 20-80% of small bowel resection,'-2 1 jejunoileal bypass,'4 '' subtotal colectomy,'6 colostomy closure,'7 pancreaticobiliary diversion," and topical instillation of bile acids." These manoeuvres are all associated with increased colonic tumourigenesis.`1 [9][10][11][12][13][14][15][16][17][18][19][20][21][22] In man, there seems to be an expanded colonic crypt cell proliferative compartment in a number of situations associated with an increased risk of colorectal cancer, including in subjects with a family history of colorectal cancer23 and in patients with ulcerative colitis,24 as well as those with sporadic adenoma or cancer'0 25 and those with familial adenomatous polyposis. 23 It is of interest that supplementary calcium is able to abolish the increased tumour yield after enterectomy26 and will also reduce crypt cell production.27 While the evidence linking increased cell proliferation and colorectal cancer is good, the converse is less clear cut.…”

mentioning

confidence: 99%

Dietary calcium does not reduce experimental colorectal carcinogenesis after small bowel resection despite reducing cellular proliferation.

Barsoum

Thompson

Neoptolemos

et al. 1992

Gut

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Suture technique affects perianastomotic colonic crypt cell production and tumour formation

O’Donnell

O'Connell

Royston

et al. 1991

Journal of British Surgery

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Suture line recurrence is an important cause of failure after potentially curative resection for colonic carcinoma. Our aim was to determine whether suture technique affected the incidence of perianastomotic tumours in experimentally induced colonic cancer. Sprague-Dawley rats were randomized into three groups. A 1 cm longitudinal colotomy was repaired with four interrupted 6/0 polypropylene monofilament sutures, using either a transmural technique (n = 18) or a seromuscular technique (n = 18). Control animals (n = 18) had a sham laparotomy. All animals received nine, weekly, subcutaneous injections of azoxymethane (total dose 90 mg/kg) starting 6 weeks after laparotomy. Surviving animals were killed 32 weeks after laparotomy. Five animals from each group were given intraperitoneal bromodeoxyuridine (100 mg/kg) 1 h before being killed. At death, perianastomotic tumours occurred more frequently in animals with transmural sutures than in either controls or those with seromuscular sutures. This difference was associated with a greater mucosal bromodeoxyuridine crypt cell labelling index in the transmural suture group. We conclude that a transmural anastomotic suture technique promotes the development of experimental perianastomotic colonic tumours.

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Effect of major small bowel resection on dimethylhydrazine‐induced bowel carcinogenesis

Cited by 8 publications

References 21 publications

The Influence of the Interaction of Sutures with the Mucosa on Tumour Formation at Colonic Anastomoses in Rats

The Influence of the Interaction of Sutures with the Mucosa on Tumour Formation at Colonic Anastomoses in Rats

Dietary calcium does not reduce experimental colorectal carcinogenesis after small bowel resection despite reducing cellular proliferation.

Suture technique affects perianastomotic colonic crypt cell production and tumour formation

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