Moran Munevver, Ozmen M Mahir, Duzgun A Polat, Gok Riza, Renda Nurten, Seckin Selda, Coskun Faruk
Department of Surgery, Ankara Numune Teaching and Research Hospital, Ankara, Turkey.
World J Emerg Surg. 2007 May 15;2:13. doi: 10.1186/1749-7922-2-13.
Anastomotic leakage is an important problem following primary resection in the left colon and is even more prominent when obstruction is present. We aimed to evaluate the possible effects of erythropoietin on the healing of anastomosis under both obstructive and non-obstructive states.
Forty male Wistar albino rats were divided into four groups. In group I, two cm left colonic resection and primary anastomosis were done. In group II, left colon were completely ligated and 24 hours later animals were re-operated for segmental resection. The same procedures were performed for rats in group III and IV in respect to group I and II and, 500 IU/kg a day erythropoietin were given in the latter two groups for seven days. For the quantative description of anastomotic healing mechanical, biochemical and histopathological parameters were employed on the seventh day and the animals were sacrificied.
Although erythropoietin had positive effects on bursting pressure in group IV when compared to group II, it has no effect in group III. Despite the increased tissue hydroxyproline levels in group IV, erythropoietin failed to show any effects in group III. Erythropoietin had positive effects on neovascularization, fibroblast proliferiation and storage of collagen in group IV.
We failed to find any direct and evident effects of erythropoietin on healing of left colonic anastomosis. On the other hand, erythropoietin might prevent negative effects of obstruction on healing.
吻合口漏是左半结肠一期切除术后的一个重要问题,在存在梗阻时更为突出。我们旨在评估促红细胞生成素在梗阻和非梗阻状态下对吻合口愈合的可能影响。
40只雄性Wistar白化大鼠分为四组。第一组,行左半结肠2 cm切除并一期吻合。第二组,将左半结肠完全结扎,24小时后再次手术行节段性切除。第三组和第四组大鼠分别参照第一组和第二组进行相同操作,后两组大鼠每天给予500 IU/kg促红细胞生成素,共7天。在第7天采用机械、生化和组织病理学参数对吻合口愈合进行定量描述,并处死动物。
与第二组相比,促红细胞生成素对第四组的破裂压力有积极影响,但对第三组无影响。尽管第四组组织羟脯氨酸水平升高,但促红细胞生成素对第三组未显示出任何影响。促红细胞生成素对第四组的新生血管形成、成纤维细胞增殖和胶原蛋白沉积有积极影响。
我们未发现促红细胞生成素对左半结肠吻合口愈合有任何直接和明显的影响。另一方面,促红细胞生成素可能预防梗阻对愈合的负面影响。