Li Zhanwu, Wang Wenjun, Wang Xiaozhou, Jiang Lei, Wang Fengyi, Liu Qiang
Department of Emergency Surgery, Affiliated Zhongshan Hospital of Dalian University, Liaoning, China.
Ann Surg Treat Res. 2017 Sep;93(3):159-165. doi: 10.4174/astr.2017.93.3.159. Epub 2017 Aug 30.
To investigate the effects of a sustained-released mixture of vascular endothelial growth factor 165 (VEGF165) and fibrin glue (FG) local administration on postoperative rabbit ileal anastomoses.
One hundred twenty-eight male and female New Zealand white rabbits underwent intraperitoneal infection subsequent ileal anastomosis surgery were divided randomly into 4 groups, including 32 animals in each, applied with saline solution, FG, rhVEGF165 and a mixture of rhVEGF165 with FG (VEGF + FG) on the anastomoses, respectively. The incidences of anastomotic leakage were observed. Histopathological examination for inflammatory infiltration, fibroblast proliferation, and capillary vascular proliferation were performed. Then, bursting pressure and hydroxyproline concentrations were assessed in anastomoses sits on postoperative days 3, 5, 7, and 14.
Rabbits in VEGF + FG group had the lowest incidence of leakage (P < 0.05). Histological evaluations revealed that granulation tissue was formed on days 5 after anastomosis; fibroblast proliferation and capillary vascular proliferation were significantly increased on days 7 and 14 in VEGF + FG group. Furthermore, there was a statistically significant difference in the mean bursting pressures between VEGF + FG group and other groups on days 7 and 14 (P < 0.05), and rabbits in VEGF + FG group exhibited a higher concentration than VEGF group (P < 0.05) and FG group (P < 0.05) on day 14.
Administration of VEGF165 mixed with FG to ileal anastomosis accelerates wound healing and enhances the anastomosis by increased angiogenesis.
探讨血管内皮生长因子165(VEGF165)与纤维蛋白胶(FG)缓释混合物局部给药对兔回肠吻合术后的影响。
128只新西兰大白兔雌雄不限,行腹腔感染后回肠吻合术,随机分为4组,每组32只,分别在吻合口处应用生理盐水、FG、重组人血管内皮生长因子165(rhVEGF165)以及rhVEGF165与FG的混合物(VEGF+FG)。观察吻合口漏的发生率。进行组织病理学检查以评估炎症浸润、成纤维细胞增殖和毛细血管增殖情况。然后,在术后第3、5、7和14天评估吻合口处的破裂压力和羟脯氨酸浓度。
VEGF+FG组兔的吻合口漏发生率最低(P<0.05)。组织学评估显示,吻合术后第5天形成肉芽组织;VEGF+FG组在第7天和第14天的成纤维细胞增殖和毛细血管增殖明显增加。此外,VEGF+FG组与其他组在第7天和第14天的平均破裂压力存在统计学显著差异(P<0.05),且VEGF+FG组兔在第14天的羟脯氨酸浓度高于VEGF组(P<0.05)和FG组(P<0.05)。
在回肠吻合术中应用VEGF165与FG的混合物可通过增加血管生成来加速伤口愈合并增强吻合效果。