Gonçalves Carolina Gomes, Groth Anne Karoline, Ferreira Marcelo, Matias Jorge Eduardo F, Coelho Júlio Cezar U, Campos Antonio Carlos L
Department of Surgery, Hospital das Clinicas, Federal University of Paraná, Curitiba, PR, Brazil.
JPEN J Parenter Enteral Nutr. 2009 Jan-Feb;33(1):83-9. doi: 10.1177/0148607108327047.
Malnutrition influences healing of gastrointestinal anastomoses. The authors hypothesize that colonic anastomotic healing is decreased by malnutrition and might be improved by preoperative feeding.
Eighty adult male Wistar rats were divided into 4 groups: (1) control rats 1 (C1), fed regular chow ad libitum for 21 days; (2) malnourished pair-fed rats (M), fed 50% of the food ingested by the control rats for 21 days; (3) preoperative nutrition rats (PRE), fed 50% of the average of the controls for 21 days and then fed preoperative nutrition with regular chow ad libitum for 1 week before the operation; and (4) control rats 2 (C2), fed regular chow ad libitum for 28 days. On days 21 (C1 and M) and 28 (PRE and C2), rats underwent 2 colonic transections and, subsequently, 2 end-to-end anastomoses. Rats were killed on postoperative day 5. The anastomoses were resected for tensile strength and histological analysis.
PRE rats showed increased maximal tensile strength vs the M group (0.09+/-0.01 vs 0.15+/-0.01; P<.05) and similar values of maximal tensile strength as the controls (0.15+/-0.01 vs 0.15+/-0.02; P=.91). Collagen type I was higher in controls vs the PRE group (6.13+/-0.39 vs 4.90+/-1.53; P<.05); nevertheless, the PRE group showed higher collagen type I than M rats (4.90+/-0.36 vs 3.83+/-0.35; P<.05).
Preoperative feeding for 7 days increases the maximal tensile strength, as well as the percentage area of mature collagen, approaching similar values as the control group.
营养不良会影响胃肠道吻合口的愈合。作者推测，营养不良会降低结肠吻合口的愈合能力，而术前喂养可能会改善这种情况。
80只成年雄性Wistar大鼠被分为4组：（1）对照大鼠1组（C1），自由进食普通饲料21天；（2）营养不良的配对喂养大鼠组（M），给予对照大鼠摄食量50%的食物，持续21天；（3）术前营养大鼠组（PRE），给予对照大鼠平均摄入量50%的食物，持续21天，然后在手术前1周自由进食普通饲料进行术前营养补充；（）对照大鼠2组（C2），自由进食普通饲料28天。在第21天（C1和M组）和第28天（PRE和C2组），大鼠接受2次结肠横断术，随后进行2次端端吻合术。术后第5天处死大鼠。切除吻合口进行抗张强度和组织学分析。
与M组相比，PRE组大鼠的最大抗张强度增加（0.09±0.01对0.15±0.01；P<0.05），且最大抗张强度值与对照组相似（0.15±0.01对0.15±0.02；P=0.91）。对照组的I型胶原蛋白含量高于PRE组（6.13±0.39对4.90±1.53；P<0.05）；然而，PRE组的I型胶原蛋白含量高于M组大鼠（4.90±0.36对3.83±0.35；P<0.05）。
术前喂养7天可增加最大抗张强度以及成熟胶原蛋白的面积百分比，接近对照组的数值。
