Ozel Leyla, Ozel M Sefa, Toros Ahmet Burak, Kara Melih, Ozkan Kemal Sirri, Tellioglu Gurkan, Krand Osman, Koyuturk Meral, Berber Ibrahim
Haydarpaşa Numune Education and Research Hospital, Deparment of General Surgery, Istanbul 34668, Turkey.
World J Gastroenterol. 2009 Sep 7;15(33):4156-62. doi: 10.3748/wjg.15.4156.
To determine the effect of chemotherapy on wound healing by giving early preoperative 5-fluorouracil (5-FU) to rats with colonic anastomoses.
Sixty Albino-Wistar male rats (median weight, 235 g) were used in this study. The rats were fed with standard laboratory food and given tap water ad libitum. The animals were divided into three groups: Group 1: Control group (chemotherapy was not administered), Group 2: Intraperitoneally (i.p.) administered 5-FU group (chemotherapy was administered i.p. to animals at a dose of 20 mg/kg daily during the 5 d preceding surgery), Group 3: Intravenously (i.v.) administered 5-FU group. Chemotherapy was administered via the penil vein, using the same dosing scheme and duration as the second group. After a 3-d rest to minimize the side effects of chemotherapy, both groups underwent surgery. One centimeter of colon was resected 2 cm proximally from the peritoneal reflection, then sutured intermittently and subsequently end-to-end anastomosed. In each group, half the animals were given anaesthesia on the 3rd postoperative (PO) day and the other half on the 7th PO day, for in vivo analytic procedures. The abdominal incisions in the rats were dissected, all the new and old anastomotic segments were clearly seen and bursting pressures of each anastomotic segment, tissue hydroxyproline levels and DNA content were determined to assess the histologic tissue repair process.
When the i.v. group was compared with the i.p. group, bursting pressures of the anastomotic segments on the 3rd and 7th PO days, were found to be significantly decreased, hydroxyproline levels at the anastomotic segment on the 7th PO day were significantly decreased (P < 0.01).
In this study, we conclude that early preoperative 5-FU, administered i.v., negatively affects wound healing. However, i.p. administered 5-FU does not negatively affect wound healing.
通过对行结肠吻合术的大鼠术前早期给予5-氟尿嘧啶(5-FU),以确定化疗对伤口愈合的影响。
本研究使用60只白化Wistar雄性大鼠(中位体重235 g)。大鼠喂食标准实验室饲料并随意饮用自来水。动物被分为三组:第1组:对照组(未给予化疗),第2组:腹腔内(i.p.)给予5-FU组(在手术前5天每天以20 mg/kg的剂量腹腔内给予动物化疗),第3组:静脉内(i.v.)给予5-FU组。化疗通过阴茎静脉给药,使用与第二组相同的给药方案和持续时间。在休息3天以尽量减少化疗的副作用后,两组均接受手术。从腹膜反折处向近端2 cm处切除1 cm的结肠,然后间断缝合,随后进行端端吻合。在每组中,一半的动物在术后(PO)第3天给予麻醉,另一半在PO第7天给予麻醉,用于体内分析程序。解剖大鼠的腹部切口,清楚地观察到所有新的和旧的吻合段,并测定每个吻合段的破裂压力、组织羟脯氨酸水平和DNA含量,以评估组织学组织修复过程。
当静脉内给药组与腹腔内给药组比较时,发现PO第3天和第7天吻合段的破裂压力显著降低,PO第7天吻合段的羟脯氨酸水平显著降低(P < 0.01)。
在本研究中,我们得出结论,术前早期静脉内给予5-FU对伤口愈合有负面影响。然而,腹腔内给予5-FU对伤口愈合没有负面影响。