Department of Surgery, Skåne University Hospital, Malmö, Sweden.
Colorectal Dis. 2011 Jul;13(7):e165-9. doi: 10.1111/j.1463-1318.2011.02633.x.
Our aim was to define the dynamics in collagen concentrations in the large bowel wall following decompression of experimental obstruction.
Colonic obstruction was created in 28 male rats by the placement of a silicone ring around the distal colon. The ring was removed after 4 days to mimic endoscopical decompression by stent deployment. Colon circumference and collagen concentration were measured proximal to the obstructed segment immediately and at 3 and 10 days after decompression. The corresponding colonic sites of 23 sham-operated and eight nonoperated control animals were subjected to identical analyses.
Four days of obstruction resulted in a more than twofold increase in colonic circumference (20 vs 8 mm), with a concomitant 43% reduction (P = 0.001) in collagen concentration in the bowel wall proximal to the obstruction compared with sham animals. Three days after decompression, collagen concentrations remained reduced (P < 0.05), while there was no significant difference after 10 days with either sham-operated or nonoperated controls. Colonic circumference of the obstructed colon remained slightly distended (11 mm) on day 10 and tended to correlate (r(S) = 0.51, P = 0.053) with total matrix metalloproteinase activity.
The marked reduction in collagen concentration in an experimentally obstructed colon is normalized 10 days after decompression. These findings may have clinical implications for the timing of surgical resection.
本研究旨在明确实验性肠梗阻减压后大肠壁胶原浓度的动态变化。
通过在大鼠远端结肠放置硅酮环来建立结肠梗阻模型。4 天后移除硅酮环以模拟支架扩张的内镜减压。在梗阻段近端立即以及减压后 3 天和 10 天测量结肠周长和胶原浓度。对 23 只假手术和 8 只未手术对照组的相应结肠部位进行了相同的分析。
梗阻 4 天导致结肠周长增加了两倍多（20 毫米对 8 毫米），而与假手术组相比，梗阻段近端肠壁胶原浓度降低了 43%（P = 0.001）。减压后 3 天，胶原浓度仍降低（P < 0.05），10 天后与假手术或未手术对照组均无显著差异。梗阻结肠的结肠周长在第 10 天仍略扩张（11 毫米），并与总基质金属蛋白酶活性呈正相关（r(S) = 0.51，P = 0.053）。
实验性梗阻结肠中胶原浓度的显著降低在减压后 10 天恢复正常。这些发现可能对手术切除的时机具有临床意义。
