Unal B, Karabeyoglu M, Huner T, Canbay E, Eroglu A, Yildirim O, Dolapci M, Bilgihan A, Cengiz O
Department of Surgery, Faculty of Medicine, Inonu University, Malatya, Turkey.
Surg Innov. 2009 Mar;16(1):21-5. doi: 10.1177/1553350608328584. Epub 2008 Dec 8.
Ethyl pyruvate is a simple derivative in Ca(+2)- and K(+)-containing balanced salt solution of pyruvate to avoid the problems associated with the instability of pyruvate in solution. It has been shown to ameliorate the effects of ischemia-reperfusion (I/R) injury in many organs. It has also been shown that I/R injury delays the healing of colonic anastomosis. In this study, the effect of ethyl pyruvate on the healing of colon anastomosis and anastomotic strength after I/R injury was investigated. Anastomosis of the colon was performed in 32 adult male Wistar albino rats divided into 4 groups of 8 individuals: (1) sham-operated control group (group 1); (2) 30 minutes of intestinal I/R by superior mesenteric artery occlusion (group 2); (3) I/R+ ethyl pyruvate (group 3), ethyl pyruvate was administered as a 50-mg/kg/d single dose; and (4) I/R+ ethyl pyruvate (group 4), ethyl pyruvate administration was repeatedly (every 6 hours) at the same dose (50 mg/kg). On the fifth postoperative day, animals were killed. Perianastomotic tissue hydroxyproline contents and anastomotic bursting pressures were measured in all groups. When the anastomotic bursting pressures and tissue hydroxyproline contents were compared, it was found that they were decreased in group 2 when compared with groups 1, 3, and 4 (P < .05). Both anastomotic bursting pressure (P = .005) and hydroxyproline content (P < .001) levels were found to be significantly increased with ethyl pyruvate administration when compared with group 2. When ethyl pyruvate administration doses were compared, a significant difference was not observed (P > .05). Ethyl pyruvate significantly prevents the delaying effect of I/R injury on anastomotic strength and healing independent from doses of administration.
丙酮酸乙酯是丙酮酸在含钙离子和钾离子的平衡盐溶液中的一种简单衍生物,以避免与丙酮酸在溶液中不稳定相关的问题。已证明它可改善许多器官的缺血再灌注(I/R)损伤的影响。还表明I/R损伤会延迟结肠吻合口的愈合。在本研究中,研究了丙酮酸乙酯对I/R损伤后结肠吻合口愈合和吻合强度的影响。对32只成年雄性Wistar白化大鼠进行结肠吻合,分为4组,每组8只:(1)假手术对照组(第1组);(2)通过肠系膜上动脉闭塞进行30分钟的肠I/R(第2组);(3)I/R +丙酮酸乙酯(第3组),丙酮酸乙酯以50 mg/kg/d的单剂量给药;(4)I/R +丙酮酸乙酯(第4组),丙酮酸乙酯以相同剂量(50 mg/kg)重复给药(每6小时一次)。术后第5天,处死动物。测量所有组的吻合口周围组织羟脯氨酸含量和吻合口破裂压力。比较吻合口破裂压力和组织羟脯氨酸含量时,发现第2组与第1、3和4组相比降低(P <.05)。与第2组相比,给予丙酮酸乙酯后吻合口破裂压力(P =.005)和羟脯氨酸含量(P <.001)水平均显著升高。比较丙酮酸乙酯给药剂量时,未观察到显著差异(P>.05)。丙酮酸乙酯可显著预防I/R损伤对吻合强度和愈合的延迟作用,且与给药剂量无关。