奥曲肽对术后即刻腹腔内给予5-氟尿嘧啶的结肠损伤吻合口愈合的影响

The effect of octreotide on healing of injured colonic anastomosis with immediate postoperative intraperitoneal administration of 5-Fluorouracil.

作者信息

Colak Tahsin, Dag Ahmet, Turkmenoglu Ozgur, Polat Ayse, Comelekoglu Ulku, Bagdatoglu Ozlen, Polat Gurbuz, Akca Tamer, Sucullu Ilker, Aydin Suha

机构信息

Faculty of Medicine, Department of General Surgery, Mersin University, Tip Fakultesi Hastanesi, Zetinlibahce C., Mersin, 33097, Turkey.

出版信息

Dis Colon Rectum. 2007 May;50(5):660-9. doi: 10.1007/s10350-006-0810-0.

DOI:10.1007/s10350-006-0810-0

PMID:17216142

Abstract

PURPOSE

This study was designed to investigate the effect of octreotide on side effects of immediate usage of 5-fluorouracil after colonic anastomosis.

METHODS

Forty male Wistar rats were randomly assigned into four groups and underwent standardized left colonic anastomosis. The rats served as control or received intraperitoneal 5-fluorouracil (20 mg/kg daily), subcutaneous octreotide (20 mug/kg daily), or both. Diarrhea and wound complications were noted during the experiment. The colonic anastomoses were assessed for healing on postoperative Day 7 by determining the anastomotic bursting pressure, performing histologic examination, and measuring the tissue hydroxyproline content, serum malondialdehyde, and nitric oxide levels. Intraperitoneal adhesions and anastomotic leakage were also noted.

RESULTS

No statistical significant difference was found between the control and octreotide groups for each of the parameters measured. Immediate 5-fluorouracil use resulted with higher adhesion score (P = 0.002), significant depression in anastomotic bursting pressure (P = 0.0001), histopathologic score (P = 0.0001), hydroxyproline content (P = 0.0001), and increasing nitric oxide (P = 0.0001) and malondialdehyde levels (P = 0.0001) compared with the control group. Diarrhea was seen in 80 percent of the 5-fluorouracil group but in neither the control nor octreotide groups (P = 0.0001 for each comparison). However, all these parameters were ameliorated by use of concomitant octreotide and 5-fluorouracil (P = 0.019, P = 0.023, P = 0.0001, P = 0.006, P = 0.0001, and P = 0.013, respectively). In addition, diarrhea was found to be prevented (P = 0.0001).

CONCLUSIONS

The results of this study showed that concomitant octreotide use might prevent the side effects of 5-fluorouracil, such as diarrhea, postoperative adhesion, and delaying the anastomotic healing parameters. In addition, it might reduce tissue damage and inflammation.

摘要

目的

本研究旨在探讨奥曲肽对结肠吻合术后立即使用5-氟尿嘧啶的副作用的影响。

方法

40只雄性Wistar大鼠随机分为四组，接受标准化的左半结肠吻合术。大鼠作为对照组或接受腹腔注射5-氟尿嘧啶（每日20mg/kg）、皮下注射奥曲肽（每日20μg/kg）或两者联合使用。实验期间记录腹泻和伤口并发症情况。术后第7天，通过测定吻合口破裂压力、进行组织学检查以及测量组织羟脯氨酸含量、血清丙二醛和一氧化氮水平，评估结肠吻合口的愈合情况。同时记录腹腔粘连和吻合口漏情况。

结果

在测量的各项参数中，对照组和奥曲肽组之间未发现统计学显著差异。与对照组相比，立即使用5-氟尿嘧啶导致粘连评分更高（P = 0.002），吻合口破裂压力显著降低（P = 0.0001）、组织病理学评分降低（P = 0.0001）、羟脯氨酸含量降低（P = 0.0001），一氧化氮（P = 0.0001）和丙二醛水平升高（P = 0.0001）。5-氟尿嘧啶组80%的大鼠出现腹泻，而对照组和奥曲肽组均未出现腹泻（每次比较P = 0.0001）。然而，同时使用奥曲肽和5-氟尿嘧啶可改善所有这些参数（分别为P = 0.019、P = 0.023、P = 0.0001、P = 0.006、P = 0.0001和P = 0.013）。此外，腹泻得到预防（P = 0.0001）。