术后即刻腹腔内给予5-氟尿嘧啶后用纤维蛋白胶覆盖的结肠吻合口愈合情况。

Healing of colon anastomoses covered with fibrin glue after immediate postoperative intraperitoneal administration of 5-fluorouracil.

作者信息

Kanellos I, Mantzoros I, Demetriades H, Kalfadis S, Kelpis T, Sakkas L, Betsis D

机构信息

4th Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

Dis Colon Rectum. 2004 Apr;47(4):510-5. doi: 10.1007/s10350-003-0085-7. Epub 2004 Feb 26.

DOI:10.1007/s10350-003-0085-7

PMID:14978614

Abstract

PURPOSE

The aim of this experimental study was to investigate whether covering the colonic anastomoses with fibrin glue can protect the colonic healing from the adverse effects of 5-fluorouracil (5-FU), when it is injected intraperitoneally immediately after colon resection.

METHODS

Sixty-four rats were randomized to one of four groups. After resection of a 1-cm segment of the transverse colon, an end-to-end sutured anastomosis was performed. Rats of the control group and the fibrin glue group were injected with 6 ml of solution 0.9 percent NaCl intraperitoneally. Rats in the 5-FU and the 5-FU + fibrin glue groups received 5-FU intraperitoneally. The colonic anastomoses of the rats in the fibrin glue group and in the 5-FU + fibrin glue group were covered with fibrin glue. All rats were killed on the 8th postoperative day and the anastomoses were examined macroscopically. The bursting pressure measurements were recorded and the anastomoses were graded histologically.

RESULTS

The leakage rate of the anastomoses was significantly higher in the rats of the 5-FU group than in those of the fibrin glue group and those of the 5-FU + fibrin glue group (37.5 percent vs. 0 percent, P = 0.020). The adhesion formation score was significantly higher in rats of the 5-FU group than in the other groups. Bursting pressures were also significantly lower in the 5-FUgroup than in the other groups ( P < 0.001). Rats in the 5-FU + fibrin glue group developed significantly more marked neoagiogenesis than rats in the other groups. Rats in the 5-FU + fibrin glue group also presented significantly more fibroblast activity than those in the 5-FU group. ( P = 0.004)

CONCLUSIONS

The immediate postoperative, intraperitoneal administration of 5-FU inhibited wound healing. However, when the colonic anastomoses were covered with fibrin glue, the injection of 5-FU had no adverse effects on the healing of the anastomoses.

摘要

目的

本实验研究旨在探讨在结肠切除术后立即腹腔注射5-氟尿嘧啶（5-FU）时，用纤维蛋白胶覆盖结肠吻合口是否能保护结肠愈合免受5-FU的不良影响。

方法

64只大鼠被随机分为四组之一。切除1厘米横结肠段后，进行端端缝合吻合。对照组和纤维蛋白胶组大鼠腹腔注射6毫升0.9%氯化钠溶液。5-FU组和5-FU+纤维蛋白胶组大鼠腹腔注射5-FU。纤维蛋白胶组和5-FU+纤维蛋白胶组大鼠的结肠吻合口用纤维蛋白胶覆盖。所有大鼠在术后第8天处死，对吻合口进行宏观检查。记录破裂压力测量值，并对吻合口进行组织学分级。

结果

5-FU组大鼠吻合口漏率显著高于纤维蛋白胶组和5-FU+纤维蛋白胶组大鼠（37.5%对0%，P=0.020）。5-FU组大鼠的粘连形成评分显著高于其他组。5-FU组的破裂压力也显著低于其他组（P<0.001）。5-FU+纤维蛋白胶组大鼠的新生血管生成明显比其他组大鼠更显著。5-FU+纤维蛋白胶组大鼠的成纤维细胞活性也显著高于5-FU组（P=0.004）。