Erguder Ender, Celik Merve, Eser Pinar Eylem, Durhan Abdullah, Hucumenoglu Sema, Akkus Mehmet Ali, Buyukserin Fatih
Department of General Surgery, Ankara Training and Research Hospital, Ankara, Türkiye.
Department of Biomedical Engineering, TOBB Economy and Technology University, Ankara, Türkiye.
J Biomed Mater Res B Appl Biomater. 2025 Jan;113(1):e35518. doi: 10.1002/jbm.b.35518.
Despite the variety of proposed solutions, anastomotic leakage is still a critical complication after colorectal surgery, which causes increased clinical mortality and morbidity. By enhancing microcirculation in the colonic mucosa, the use of Iloprost (Ilo) has shown promising results for the healing of anastomosis. The purpose of this study is to examine the performance of Ilo-impregnated Polycaprolactone:Gelatin electrospun membranes (PCL/Gel/Ilo) on anastomosis repair and intra-abdominal adhesion behavior in the Rat colon. Wistar Albino rats were randomly divided into four groups: sham, Control (only resection-anastomosis), PCL/Gel, and PCL/Gel /Ilo (n = 12 for each). On the seventh day after colon anastomosis, a second laparotomy was conducted. During this procedure, intra-abdominal adhesion was examined, and the anastomotic segment was removed for burst pressure and histological evaluation. There was no statistically significant difference in intra-abdominal adhesions and major complications between the electrospun membrane groups and the control group. The membrane-applied groups exhibited significantly higher anastomotic burst pressure than the control group irrespective of their Ilo content. In terms of neovascularization and muscle necrosis, membrane-applied groups demonstrated statistically significant improvements over the control group. Furthermore, the PCL/Gel/Ilo applied group showed enhanced neovascularization and lower muscular necrosis; however, statistically significant differences were not observed compared to the PCL/Gel applied group. Compared to the control group, the application of electrospun PCL/Gel and PCL/Gel/Ilo membranes resulted in safe and effective healing of colon anastomosis. The fact that Ilo application cannot be distinguished from the regular membrane group necessitates additional research into the doped fibrous mat and its application method.
尽管提出了各种解决方案，但吻合口漏仍是结直肠手术后的一种关键并发症，会导致临床死亡率和发病率上升。通过增强结肠黏膜的微循环，使用伊洛前列素（Ilo）已显示出在吻合口愈合方面有良好效果。本研究的目的是检验负载伊洛前列素的聚己内酯：明胶电纺膜（PCL/Gel/Ilo）对大鼠结肠吻合口修复及腹腔内粘连行为的影响。将Wistar白化大鼠随机分为四组：假手术组、对照组（仅切除 - 吻合术）、PCL/Gel组和PCL/Gel /Ilo组（每组n = 12）。结肠吻合术后第7天，进行第二次剖腹手术。在此过程中，检查腹腔内粘连情况，并取出吻合段进行破裂压力和组织学评估。电纺膜组与对照组在腹腔内粘连和主要并发症方面无统计学显著差异。无论伊洛前列素含量如何，应用膜的组吻合口破裂压力均显著高于对照组。在新生血管形成和肌肉坏死方面，应用膜的组与对照组相比有统计学显著改善。此外，PCL/Gel/Ilo应用组显示出增强的新生血管形成和更低的肌肉坏死；然而，与PCL/Gel应用组相比未观察到统计学显著差异。与对照组相比，电纺PCL/Gel和PCL/Gel/Ilo膜的应用导致结肠吻合口安全有效愈合。伊洛前列素应用与常规膜组无法区分这一事实需要对掺杂纤维垫及其应用方法进行进一步研究。
