Influence of 5-Fluorouracil on Colonic Healing and Expression of Transforming Growth Factor-Beta 1

Fukuchi, Steven G.; Seeburger, Jeffrey L.; Parquet, Guido; Rolandelli, Rolando H.

doi:10.1006/jsre.1999.5626

Cited by 24 publications

(21 citation statements)

References 28 publications

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“…Local adhesions around the anastomosis are seen in many animals and should not be dissected to prevent falsification of bursting pressure values. Thus, an ex situ bursting pressure measurement directly after resection of the anastomosis-bearing segment can be reliably performed, although some researchers have proposed in situ measurement [16,28] .…”

Section: Discussionmentioning

confidence: 99%

Pitfalls and Technical Aspects during the Research of Intestinal Anastomotic Healing in Rats

Marjanović

Holzner²,

Kulemann³

et al. 2010

Eur Surg Res

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Background: Fundamental experimental research into intestinal anastomotic healing in rodent models will gain increasing interest in the future. Methods: The aim of this study was to describe our 5-year experience with a standardized experimental setup of small and large bowel anastomoses in a rodent model and present a basic set of assessment tools investigating anastomotic healing. Anastomotic technique, perioperative complications such as anastomotic insufficiency (AI) and obstructive ileus were in the focus. Results: During different studies with varying study patterns, 167 rat small bowel anastomoses and 120 colonic anastomoses were performed. Overall mortality was 3.6% in small bowel and 2.5% in colonic anastomoses, AI occurred in 2.9 and 4%, respectively. A postoperative obstructive ileus was seen in 3/167 small bowel anastomoses and none in the colonic group. Conclusion: When performing experimental intestinal anastomoses in a standardized operative setting and critically considering special perioperative issues, the incidence of relevant complications can be maintained at an adequately low level.

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Section: Discussionmentioning

confidence: 99%

Pitfalls and Technical Aspects during the Research of Intestinal Anastomotic Healing in Rats

Marjanović

Holzner²,

Kulemann³

et al. 2010

Eur Surg Res

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“…2 Any delay or impairment of the fibroplasia phase can result in the potentially catastrophic consequence of anastomotic dehiscence. 3 Indeed, it is at the end of the first postoperative week that anastomotic dehiscences usually occur and become clinically evident.…”

Section: Discussionmentioning

confidence: 99%

“…The role of transforming growth factor-beta 1 (TGF-␤1) in this process has been well documented by our group in rat models of both normal and impaired colonic healing. [1][2][3] We have previously demonstrated a temporal relationship in colonic healing between the increasing levels of transcription of TGF-␤1 to procollagen I upregulation with maximal mRNA expression of both of these factors on postoperative day 7. These local increases in TGF-␤1 expression are diminished by the administration of 5-fluorouracil (5-FU) with impairment of colonic anastomotic healing.…”

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confidence: 97%

Effect of Adenoviral-Mediated Transfer of Transforming Growth Factor-β1 on Colonic Anastomotic Healing

Migaly

Lieberman

Long

et al. 2004

Diseases of the Colon &Amp; Rectum

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Gene transfer into the healing colonic anastomosis can be effectively achieved via intraluminal administration of adenoviral vectors. Transfer of transforming growth factor-beta1 increased the strength of colonic anastomoses when given at Day 3 but not at Day 0, demonstrating its diverse effects in the wound healing sequence. Thus, gene transfer of transforming growth factor-beta1 may avoid the need for a diverting stoma in cases of rectal surgery and impaired healing resulting from chemotherapy or radiation.

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“…After the initial inflammatory phase, a proliferative phase ensues consisting of the formation of granulation tissue, including synthesis of noncollagenous protein such as fibronectin, and loss of colonic wall collagen in the tissue adjacent to the anastomosis (16). During the first few postoperative days, anastomotic strength is low as collagen is degraded secondary to collagenase activity at the anastomosis site.…”

Section: Discussionmentioning

confidence: 99%

Safety and effectiveness of mechanical versus hand suturing of intestinal anastomoses in an animal model of peritonitis

Tajima

Kono

Ninomiya

et al. 2012

Experimental and Therapeutic Medicine

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Abstract. Mechanical stapling for colorectal anastomosis is popular, but the safety of its use for anastomosis in peritonitis is unclear. We evaluated the safety and effectiveness of mechanically stapled vs. hand-sutured anastomosis by comparing wound healing in an animal model of bacterial peritonitis. Male Sprague-Dawley (n=48) rats underwent cecal ligation and puncture. After 24 h, rats were divided into two groups: the stapler group (cecal resection with mechanical stapler, n=24) and the hand-sutured group (cecal resection and stump closure with surgical absorbable suture, n=24). Anastomotic segments were excised and as indicators of wound healing, anastomotic bursting pressure (ABP) and tissue hydroxyproline concentration were determined over time. After harvesting, anastomotic segments were analyzed by quantitative real-time polymerase chain reaction (PCR) to determine relative expression of transforming growth factor-β 1 (TGF-β 1 ) and vascular endothelial growth factor (VEGF) normalized to that of a constitutive gene. The operative time was significantly shorter in the stapler vs. the hand-sutured group. Both groups showed progressive increases in ABP over the postoperative period. ABP was significantly higher in the stapler vs. the hand-sutured group on postoperative days (PODs) 0 and 3. Tissue hydroxyproline concentration increased from POD 7 in both groups, but between-group difference was not significant. Both groups showed progressive increases in TGF-β 1 and VEGF expression during the 7-day postoperative period. On POD 5, TGF-β 1 gene expression was higher in the stapler vs. the hand-sutured group. VEGF gene expression was identical in both groups. In conclusion, anastomosis by stapler is safer and more effective than that by hand suturing in bacterial peritonitis, since it requires less operating time and creates stronger anastomoses in the early postoperative period. IntroductionAnastomotic dehiscence following gastrointestinal surgery, particularly colorectal surgery, is a significant cause of morbidity and mortality, and leakage from colonic anastomosis is a major concern for surgeons. The incidence of reported anastomotic leakage varies between 10 and 13% (1,2). Presently, the use of mechanical staplers for colorectal anastomoses has been increasing and is becoming widely accepted in Western countries due to the short procedure time and reliability afforded by this technique. It has reduced the operation time, has facilitated the performance of gastrointestinal anastomoses at sites with a poor field of view and has decreased the likelihood of suture failure (3,4). Several prospective randomized controlled studies have compared hand suturing with mechanical stapling in patients undergoing total gastrectomy and low anterior colorectal resection (5-7). However, hand-sutured anastomoses are still popular due to economic conditions in developing countries, and few experimental studies have yet been reported comparing wound healing of stapled anastomosis with hand-sutured anastomosis, particularly i...

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Influence of 5-Fluorouracil on Colonic Healing and Expression of Transforming Growth Factor-Beta 1

Cited by 24 publications

References 28 publications

Pitfalls and Technical Aspects during the Research of Intestinal Anastomotic Healing in Rats

Pitfalls and Technical Aspects during the Research of Intestinal Anastomotic Healing in Rats

Effect of Adenoviral-Mediated Transfer of Transforming Growth Factor-β1 on Colonic Anastomotic Healing

Safety and effectiveness of mechanical versus hand suturing of intestinal anastomoses in an animal model of peritonitis

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