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局部应用表皮生长因子能否预防结肠吻合口漏?

Does locally applied epidermal growth factor stop anastomotic leak in the colon?

出版信息

Ann Ital Chir. 2023;94:419-424.

Abstract

AIM

Anastomosis leakage is one of the most common complications after colorectal surgery. Studies have shown that the incidence of anastomotic leakage is between 0.5-30%. The aim of our study was to investigate the efficacy of local application of of epidermal growth factor (EGF) on colon anastomosis healing.

MATERIAL AND METHODS

28 Wistar rats were randomly divided into 4 groups. Sham group, control group, saline injection group, EGF injection group. Anastomosis line was determined as 3 cm distal to ilealcecal junction. The rats were reoperated on the 7th postoperative day. The colon segment was cut out 3 cm proximal and distal to the anastomotic line.The bursting pressure of each removed colon segment was measured and the segments were fixed with 10% formaldehyde for pathology examination. Anastomosis line was stained with hematoxylin eosin and histopathological evaluation was performed. Evaluation parameters were inflammatory cells, fibroblast, angiogenesis (neovascularization) and collagen amounts.

RESULTS

Bursting pressure was higher in the EGF group than in the control group and saline injection group. There was statistically significant difference between EGF and positive control group. (p<0,05) Histopathological examination revealed that the inflammatory cell density was higher in the positive control group than in the other groups. Fibroblast cell density, neovascularization and collagen content were higher in EGF group than the others. However, no statistically significant difference was found between the control group,saline injection group and EGF injection group.

CONCLUSION

As result of our study,we think that local application of EGF may have a positive effect on healing of colon anastomosis.

KEY WORDS

Colonic Anastomosis, Egf, Experimental, Healing.

摘要

目的

吻合口漏是结直肠手术后最常见的并发症之一。研究表明,吻合口漏的发生率在 0.5-30%之间。本研究旨在探讨表皮生长因子(EGF)局部应用对结肠吻合口愈合的疗效。

材料与方法

将 28 只 Wistar 大鼠随机分为 4 组。假手术组、对照组、生理盐水注射组、EGF 注射组。吻合线位于回盲部远端 3cm 处。术后第 7 天再次手术。从吻合线近端和远端 3cm 处取出结肠段。测量每个切除的结肠段的爆破压力,并将段固定在 10%甲醛中进行病理检查。用苏木精-伊红染色吻合线,并进行组织病理学评价。评价参数为炎症细胞、成纤维细胞、血管生成(新生血管)和胶原含量。

结果

EGF 组的爆破压高于对照组和生理盐水注射组,EGF 组与阳性对照组之间存在统计学差异(p<0.05)。组织病理学检查显示,阳性对照组的炎症细胞密度高于其他组。EGF 组的成纤维细胞密度、新生血管和胶原含量均高于其他组。然而,对照组、生理盐水注射组和 EGF 注射组之间无统计学差异。

结论

根据我们的研究结果,我们认为 EGF 的局部应用可能对结肠吻合口的愈合有积极影响。

关键词

结肠吻合术、EGF、实验、愈合。

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