Aghayeva Afag, Benlice Cigdem, Bilgin Ismail Ahmet, Atukeren Pinar, Dogusoy Gulen, Demir Figen, Atasoy Deniz, Baca Bilgi
Department of General Surgery, Acibadem University, School of Medicine, Istanbul - Turkey.
Istanbul University, Cerrahpasa Medical School, Istanbul - Turkey.
Tumori. 2017 May 12;103(3):307-313. doi: 10.5301/tj.5000610. Epub 2017 Feb 28.
Cytoreductive surgery (CRS) with subsequent hyperthermic intraperitoneal chemotherapy (HIPEC) is a promising modality to treat and prevent peritoneal metastases. However, this treatment is associated with signficant morbidity and mortality. Whether or not CRS with HIPEC interferes with anastomotic healing has also been debated. This study was designed to investigate the effects of mitomycin C, cisplatin, oxaliplatin, and doxorubicin used in HIPEC treatment on colonic anastomosis healing in a rat model.
Sixty Wistar albino rats were employed in the study. Sigmoid resection and end-to-end colorectal anastomosis was performed in all rats. Group 1 rats underwent the surgical procedure alone, while group 2 rats were given hyperthermic intraperitoneal lavage with heated saline following surgery. Groups 3, 4, 5, and 6 had surgery with concomitant HIPEC treatment with mitomycin C, cisplatin, oxaliplatin, and doxorubicin, respectively. Anastomotic bursting pressures and hydroxyproline levels were evaluated.
Regarding the hydroxyproline levels, groups 1 and 2 showed significantly higher values than other groups (p<0.001). However, there was no significant difference between the HIPEC treatment groups (groups 3, 4, 5, and 6) (p>0.05). When groups were compared regarding bursting pressure values, no significant differences were observed (p = 0.81).
This study demonstrated that the HIPEC procedure with mitomycin C, cisplatin, oxaliplatin and doxorubicin had negative effects on hydroxyproline levels, but had no detrimental effect on anastomotic bursting pressure in a rat model.
细胞减灭术（CRS）联合随后的腹腔热灌注化疗（HIPEC）是一种治疗和预防腹膜转移的有前景的方法。然而，这种治疗与显著的发病率和死亡率相关。CRS联合HIPEC是否会干扰吻合口愈合也一直存在争议。本研究旨在探讨HIPEC治疗中使用的丝裂霉素C、顺铂、奥沙利铂和阿霉素对大鼠模型结肠吻合口愈合的影响。
本研究使用了60只Wistar白化大鼠。所有大鼠均行乙状结肠切除及结直肠端端吻合术。第1组大鼠仅接受手术操作，而第2组大鼠术后接受温热盐水腹腔灌洗。第3、4、5和6组在手术的同时分别接受丝裂霉素C、顺铂、奥沙利铂和阿霉素的HIPEC治疗。评估吻合口破裂压力和羟脯氨酸水平。
关于羟脯氨酸水平，第1组和第2组的值显著高于其他组（p<0.001）。然而，HIPEC治疗组（第3、4、5和6组）之间没有显著差异（p>0.05）。当比较各组的破裂压力值时，未观察到显著差异（p = 0.81）。
本研究表明，在大鼠模型中，丝裂霉素C、顺铂、奥沙利铂和阿霉素的HIPEC程序对羟脯氨酸水平有负面影响，但对吻合口破裂压力没有不利影响。
