Dinc S, Gulcelik M A, Kuru B, Ergeneci Deniz, Camlibel M, Caydere M, Alagol H
Department of General Surgery, Ankara Oncology Training and Research Hospital, Ankara, Turkey.
Eur Surg Res. 2004 Jan-Feb;36(1):59-63. doi: 10.1159/000075076.
Ischemia is one of the most common causes of anastomosis disruption. In the present study we investigated the effect of locally injected recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) on ischemic bowel anastomosis in rats.
144 male Sprague-Dawley rats were randomized into four groups: in group 1, colon anastomoses were performed; in group 2, anastomoses were performed then 50 microg rhGM-CSF was injected subserosally into the perianastomotic area; in group 3, anastomoses were performed on ischemic colon segments, and in group 4, colon anastomoses were performed on ischemic segments and then 50 microg rhGM-CSF was injected subserosally into the perianastomotic area. On the 3rd and 7th post-operative days, the rats were sacrificed and anastomotic bursting pressures were measured. Hydroxyproline contents were studied on the tissues from the anastomotic line. Three anastomotic segments were saved from each group for histopathological studies before bursting pressure measurement.
The bursting pressure in group 3 was significantly weaker than in the other groups. There were no significant differences between the bursting pressures in groups 1 and 4. The levels of hydroxyproline content in group 4 were significantly greater than in group 3.
These data suggest that the local injection of rhGM-CSF improves the healing of ischemic and even normal colon anastomoses.
缺血是吻合口破裂最常见的原因之一。在本研究中，我们调查了局部注射重组人粒细胞巨噬细胞集落刺激因子（rhGM-CSF）对大鼠缺血性肠吻合口的影响。
144只雄性Sprague-Dawley大鼠被随机分为四组：第1组进行结肠吻合术；第2组进行吻合术后，将50微克rhGM-CSF浆膜下注射到吻合口周围区域；第3组在缺血结肠段进行吻合术；第4组在缺血段进行结肠吻合术，然后将50微克rhGM-CSF浆膜下注射到吻合口周围区域。在术后第3天和第7天，处死大鼠并测量吻合口破裂压力。对吻合口线处的组织进行羟脯氨酸含量研究。在测量破裂压力之前，从每组中保存三个吻合段用于组织病理学研究。
第3组的破裂压力明显低于其他组。第1组和第4组的破裂压力之间没有显著差异。第4组的羟脯氨酸含量水平明显高于第3组。
这些数据表明，局部注射rhGM-CSF可改善缺血甚至正常结肠吻合口的愈合。
