Pehlivanli Faruk, Aydin Oktay, Mısırlıgil Mehmet Selçuk, Peker Kevser, Kaplan İlker
Department of General Surgery, Kirikkale University School of Medicine, 71450 Kirikkale, Turkey.
Department of General Surgery, University of Health Sciences, 06010 Ankara, Turkey.
Medicina (Kaunas). 2025 May 6;61(5):851. doi: 10.3390/medicina61050851.
: Colonic anastomotic leaks are still a critical cause of morbidity and mortality. The study aimed to investigate the effects of esomeprazole on anastomotic healing after left colon anastomosis in rats with an ischemic colon. Thirty-five male Wistar albino rats were divided into acute (CONTROL-A, ESP-A) and chronic (CONTROL-C, ESP-C) stage groups. Rats in the CONTROL-A and CONTROL-C groups underwent colonic anastomosis after hypoxia-reperfusion injury in the colon, and intraperitoneal saline was administered for three and ten days, respectively. Intraperitoneal 10 mg/day esomeprazole was given to the rats in the ESP-A and ESP-C groups for three and ten days after similar surgical procedures. Then, at scheduled times, 2 cm proximal and distal regions of the anastomosis line were resected, and bursting pressure was measured. Hydroxyproline (HYP), myeloperoxidase (MPO), malondialdehyde (MDA), caspase-3 (CSP3) and catalase (CAT), nitric oxide (NO), reduced glutathione (RGT), superoxide dismutase (SOD), TNF-α, IL-6, aspartate aminotransferase (AST), alanine aminotransferase (ALT) levels were measured in tissue and blood serum samples. In the acute stage, CAT, NO, RGT, and SOD values in ESP-A group were lower than CONTROL-A group values. In addition, TNF, IL-6, ALT, and AST values in the ESP-A group were higher than the CONTROL-A group values between groups ( < 0.05). However, HYP and burst pressure values were not different between the groups. In the chronic stage, CAT, NO, RGT, SOD, CSP3, and burst pressure values in the ESP-A group were higher than CONTROL-A group values ( = 0.05). In contrast, TNF, IL-6, ALT, AST, HYP, MPO, and MDA values in the ESP-A group were lower than the CONTROL-A group values ( < 0.05). These results suggest that esomeprazole has anti-inflammatory and antioxidant activity in the chronic phase of ischemia-reperfusion injury, thus protecting the intestinal tissue from ischemic damage and enhancing the healing of the anastomosis line.
结肠吻合口漏仍是发病和死亡的关键原因。本研究旨在探讨埃索美拉唑对缺血性结肠大鼠左半结肠吻合术后吻合口愈合的影响。将35只雄性Wistar白化大鼠分为急性（对照组-A、埃索美拉唑组-A）和慢性（对照组-C、埃索美拉唑组-C）阶段组。对照组-A和对照组-C的大鼠在结肠经历缺氧-再灌注损伤后进行结肠吻合术，分别腹腔注射生理盐水3天和10天。在进行类似手术操作后，埃索美拉唑组-A和埃索美拉唑组-C的大鼠腹腔注射10mg/天的埃索美拉唑，持续3天和10天。然后，在预定时间，切除吻合线近端和远端2cm区域，并测量破裂压力。在组织和血清样本中测量羟脯氨酸（HYP）、髓过氧化物酶（MPO）、丙二醛（MDA）、半胱天冬酶-3（CSP3）、过氧化氢酶（CAT）、一氧化氮（NO）、还原型谷胱甘肽（RGT）、超氧化物歧化酶（SOD）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）水平。在急性期，埃索美拉唑组-A的CAT、NO、RGT和SOD值低于对照组-A的值。此外，埃索美拉唑组-A的TNF、IL-6、ALT和AST值高于对照组-A组间的值（P<0.05）。然而，各组间的HYP和破裂压力值无差异。在慢性期，埃索美拉唑组-A中的CAT、NO、RGT、SOD、CSP3和破裂压力值高于对照组-A的值（P=0.05）。相反，埃索美拉唑组-A中的TNF、IL-6、ALT、AST、HYP、MPO和MDA值低于对照组-A的值（P<0.05）。这些结果表明，埃索美拉唑在缺血-再灌注损伤的慢性期具有抗炎和抗氧化活性，从而保护肠道组织免受缺血损伤并促进吻合线的愈合。
