The Effect of Iloprost in the Healing of Colonic Anastomosis in Rats under Chemotherapy with Irinotecan

Arapoglou, Stergios; Kambaroudis, Apostolos; Grivas, Ioannis; Delis, Georgios; Karkos, Christos D.; Ballas, Konstantinos; Zacharioudakis, Georgios; Petras, Panagiotis; Aftzoglou, Michael; Gouziotis, Ioannis; Κολιάκος, Γεώργιος; Karakwta, Maria; Hahalis, Georgios

doi:10.21614/chirurgia.112.6.705

Cited by 5 publications

(3 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These agents can inhibit the activity of fibroblasts and decrease the deposition of collagen, which can reduce the mechanical strength of the anastomoses [28]. Moreover, intraoperative chemotherapy can suppress the process of vascularization, promote oxidative stress, and enhance the inflammatory response, which can contribute to anastomotic tissue necrosis [29,30]. Surgeons need to carefully evaluate the risks of AL for patients before conducting this treatment.…”

Section: Gastroenterology Research and Practicementioning

confidence: 99%

A Retrospective Study of Risk Factors for Symptomatic Anastomotic Leakage after Laparoscopic Anterior Resection of the Rectal Cancer without a Diverting Stoma

Wang

Liu

2020

Gastroenterology Research and Practice

View full text Add to dashboard Cite

Background. Anastomotic leakage (AL) is a common and devastating postoperative issue for patients who have undergone anterior resection of rectal carcinoma and can lead to increased short-term morbidity and mortality. Moreover, it might be associated with a worse oncological prognosis of tumors. This study is aimed at exploring the risk factors for symptomatic AL after laparoscopic anterior resection (LAR) for rectal tumors without a preventive diverting stoma. Materials and Methods. This case control study retrospectively reviewed the data of 496 consecutive patients who underwent LAR of the rectum without a preventive diverting stoma at the Cancer Hospital, Chinese Academy of Medical Sciences between September 2016 and September 2017. All patients were divided into an AL group and a control group based on the occurrence of postoperative symptomatic AL. Factors regarding patient-related variables, operation-related variables, and tumor-related variables were collected and assessed between the two groups through univariate and multivariate logistic regression analyses to identify independent risk factors for AL. Results. In total, 18 (3.6%) patients developed postoperative symptomatic AL. Univariate analysis showed that a synchronous primary malignancy of the left hemicolon (P=0.047), intraoperative chemotherapy (P=0.003), and level of anastomosis (P=0.033) were significantly related with AL. Multivariate analysis was subsequently performed to adjust for confounding biases and confirmed that a synchronous primary malignancy of the left hemicolon (odds ratio (OR), 12.225; 95% confidence interval (CI), 1.764-84.702; P=0.011), intraoperative chemotherapy (OR, 3.931; 95% CI, 1.334-11.583; P=0.013), and level of anastomosis (OR, 3.224; 95% CI, 1.124-9.249; P=0.030) were independent risk factors for symptomatic AL for patients who received LAR for rectal neoplasms without a preventive diverting stoma. Conclusions. Synchronous primary malignancy of the left hemicolon, intraoperative chemotherapy, and a low anastomotic level can increase the risks of postoperative symptomatic AL after LAR of the rectum without a protective diverting stoma.

show abstract

Section: Gastroenterology Research and Practicementioning

confidence: 99%

A Retrospective Study of Risk Factors for Symptomatic Anastomotic Leakage after Laparoscopic Anterior Resection of the Rectal Cancer without a Diverting Stoma

Wang

Liu

2020

Gastroenterology Research and Practice

View full text Add to dashboard Cite

show abstract

“…Inflammation plays a central role in the regulation of anastomotic healing. In the inflammatory phase, white blood cells are involved in the mobilization and activation of fibroblasts and epithelial cells [13]. Chemotactic agents, cytokines and inflammatory cells are concentrated in the anastomotic area from the second postoperative day [14].…”

Section: Discussionmentioning

confidence: 99%

Does Rectal Application of Red-Ginseng have an Effect on Colorectal Anastomosis Healing? An Experimental Study

Şenlikçi¹,

Koşmaz

Durhan

et al. 2021

Archives of Clinical and Experimental Medicine

View full text Add to dashboard Cite

Aim: To evaluate the possible effects of red-ginseng on colon anastomosis healing in an experimental rat model. Methods: In Group 1 (sham), laparotomy and colonic mobilization were performed. Colonic transection and anastomosis were performed to Groups 2 and 3. In Group 2 (control), 2 ml of saline was administered rectally to all rats for 10 days. Group 3 (drug group) rats were given 2.5 gr/kg ml red ginseng extract rectally for 10 days. Results: The rats in the sham group had the highest bursting pressure and the rats in the red ginseng group had higher bursting pressure than in the control group (p<0.05). A significant difference was observed only for the total SH level between the control group and the red ginseng group (p= 0.008). The red ginseng group had the highest scores for all parameters in the histopathological evaluation and the differences were significant compared to both the sham group and the control group. Conclusion: Rectally administered red-ginseng significantly increased wound healing parameters and increased anastomotic burst pressure. This is the first study in the literature on the beneficial effects of red-ginseng on colorectal anastomoses.

show abstract

“…In addition, a series of animal experiments have also indicated that intraoperative intraperitoneal chemotherapy could bring detrimental effects on the intestinal anastomosis by increasing the inflammatory reaction, promoting oxidative stress, and reducing neoangiogenesis at the anastomotic site. These effects were observed in almost all the antitumor agents commonly used in intrapertoneal chemotherapy, including mitomycin C, cisplatin, oxaliplatin, 5-fluorouracil, iritotecan, and doxorubicin[32,36,37]. Moreover, the combination use of different chemotherapeutic agents showed enhanced negative effects on the healing process of intestinal anastomoses compared to those receiving only one type of agent[38].…”

Section: Discussionmentioning

confidence: 99%

Intraoperative intraperitoneal chemotherapy increases the incidence of anastomotic leakage after anterior resection of rectal tumors

Wang¹,

Tao²,

Chen³

et al. 2019

WJGO

View full text Add to dashboard Cite

BACKGROUND Intraoperative intraperitoneal chemotherapy is an emerging treatment modality for locally advanced rectal neoplasms. However, its impacts on postoperative complications remain unknown. Anastomotic leakage (AL) is one of the most common and serious complications associated with the anterior resection of rectal tumors. Therefore, we designed this study to determine the effects of intraoperative intraperitoneal chemotherapy on AL. AIM To investigate whether intraoperative intraperitoneal chemotherapy increases the incidence of AL after the anterior resection of rectal neoplasms. METHODS This retrospective cohort study collected information from 477 consecutive patients who underwent an anterior resection of rectal carcinoma using the double stapling technique at our institution from September 2016 to September 2017. Based on the administration of intraoperative intraperitoneal chemotherapy or not, the patients were divided into a chemotherapy group (171 cases with intraperitoneal implantation of chemotherapy agents during the operation) or a control group (306 cases without intraoperative intraperitoneal chemotherapy). Clinicopathologic features, intraoperative treatment, and postoperative complications were recorded and analyzed to determine the effects of intraoperative intraperitoneal chemotherapy on the incidence of AL. The clinical outcomes of the two groups were also compared through survival analysis. RESULTS The univariate analysis showed a significantly higher incidence of AL in the patients who received intraoperative intraperitoneal chemotherapy, with 13 (7.6%) cases in the chemotherapy group and 5 (1.6%) cases in the control group ( P = 0.001). As for the severity of AL, the AL patients who underwent intraoperative intraperitoneal chemotherapy tended to be more severe cases, and 12 (92.3%) out of 13 AL patients in the chemotherapy group and 2 (40.0%) out of 5 AL patients in the control group required a secondary operation ( P = 0.044). A multivariate analysis was subsequently performed to adjust for the confounding factors and also showed that intraoperative intraperitoneal chemotherapy increased the incidence of AL (odds ratio = 5.386; 95%CI: 1.808-16.042; P = 0.002). However, the survival analysis demonstrated that intraoperative intraperitoneal chemotherapy could also improve the disease-free survival rates for patients with locally advanced rectal cancer. CONCLUSION Intraoperative intraperitoneal chemotherapy can improve the prognosis of patients with locally advanced rectal carcinoma, but it also increases the risk of AL following the anterior resection of rectal neoplasms.

show abstract

The Effect of Iloprost in the Healing of Colonic Anastomosis in Rats under Chemotherapy with Irinotecan

Cited by 5 publications

References 32 publications

A Retrospective Study of Risk Factors for Symptomatic Anastomotic Leakage after Laparoscopic Anterior Resection of the Rectal Cancer without a Diverting Stoma

A Retrospective Study of Risk Factors for Symptomatic Anastomotic Leakage after Laparoscopic Anterior Resection of the Rectal Cancer without a Diverting Stoma

Does Rectal Application of Red-Ginseng have an Effect on Colorectal Anastomosis Healing? An Experimental Study

Intraoperative intraperitoneal chemotherapy increases the incidence of anastomotic leakage after anterior resection of rectal tumors

Contact Info

Product

Resources

About