Tasdelen Afsin, Algin Cem, Ates Ersin, Kiper Haluk, Inal Mine, Sahin Fezan
Department of General Surgery, Osmangazi University Faculty of Medicine, 26480, Eskisehir, Turkey.
Hepatogastroenterology. 2004 Jul-Aug;51(58):994-7.
BACKGROUND/AIMS: Anastomotic leaks are continuing to be the source of major morbidity in colorectal surgery. Previous studies have shown that leptin acts as a growth factor for several cell types. The aim of this study was to evaluate the effect of leptin on healing of colonic anastomoses in rats.
Forty-eight rats were divided into 5 groups. Group I (n=8) sham; group II (n=10) control; right colonic anastomosis, group III (n=10); following right colonic anastomosis, treated with leptin twice-daily 1 mg/kg intraperitoneally, group IV (n=10); before right colonic anastomosis, 45 min of colonic ischemia has been created, group V (n=10); following 45 min of colonic ischemia and right colonic anastomosis, leptin was given twice-daily 1 mg/kg intraperitoneally. On the 7th postoperative day relaparotomy was performed. Bursting pressure (BP), tissue hydroxyproline concentrations (THPC), and histopathologic properties of anastomoses; vascular tissue proliferation (VTP), collagen tissue proliferation (CTP), polymorphonuclear leukocyte infiltration (PMNLI), mononuclear leukocyte infiltration (MNLI) were analyzed and results were compared statistically.
BP and THPC were found to be significantly higher in group III and group V in comparison with group II and group IV respectively (P<0.05). Histopathologically, leptin significantly increased VTP, CTP, MNLI (P<0.001), and significantly decreased PMNLI (p<0.05) on non-ischemic and ischemic colonic anastomoses.
Leptin can be used safely in colorectal surgery since it accelerates the healing of colonic anastomoses.
背景/目的：吻合口漏仍是结直肠手术中主要并发症的来源。既往研究表明，瘦素可作为多种细胞类型的生长因子。本研究旨在评估瘦素对大鼠结肠吻合口愈合的影响。
48只大鼠分为5组。I组（n = 8）为假手术组；II组（n = 10）为对照组，行右半结肠吻合术；III组（n = 10），右半结肠吻合术后，每日两次腹腔注射1 mg/kg瘦素；IV组（n = 10），在右半结肠吻合术前造成45分钟的结肠缺血；V组（n = 10），在45分钟结肠缺血及右半结肠吻合术后，每日两次腹腔注射1 mg/kg瘦素。术后第7天再次剖腹探查。分析吻合口破裂压力（BP）、组织羟脯氨酸浓度（THPC）及组织病理学特征；血管组织增殖（VTP）、胶原组织增殖（CTP）、多形核白细胞浸润（PMNLI）、单核白细胞浸润（MNLI），并对结果进行统计学比较。
与II组和IV组相比，III组和V组的BP和THPC分别显著升高（P < 0.05）。组织病理学检查显示，在非缺血和缺血性结肠吻合口中，瘦素显著增加VTP、CTP、MNLI（P < 0.001），并显著降低PMNLI（P < 0.05）。
瘦素可加速结肠吻合口愈合，因此在结直肠手术中可安全使用。
