Menteş B B, Taşcilar O, Tatlicioğlu E, Bor M V, Işman F, Türközkan N, Celebi M
Department of Surgery, Gazi University Medical School, Ankara, Turkey.
Dis Colon Rectum. 1996 Sep;39(9):1031-8. doi: 10.1007/BF02054695.
The study investigated the influence of pulsed electromagnetic fields (PEMFs) on the mechanical strength and collagen content of uncomplicated colonic anastomosis in rats.
A standardized left colonic resection was performed 3 cm above the peritoneal reflection, and end-to-end anastomosis was constructed with eight interrupted inverting sutures. Beginning immediately after surgery, randomly assigned groups were exposed to one of the following: 1) 100 Hz (frequency), 1 mT (intensity) PEMFs with 16-hour on/8-hour off cycles (n = 8); 2) 100 Hz, 2 mT PEMFs with 16-hour on/8-hour off cycles (n = 8); 3) 100 Hz, 1 mT PEMFs with 6-hour on/6-hour off cycles (n = 6), whereas the control group (n = 10) received no PEMFs. Relaparatomy was performed at 72 hours postoperatively, and the bursting pressure of the anastomotic segment was recorded in situ. The hydroxyproline contents of the anastomotic and adjacent perianastomotic segments of equal lengths were determined.
Mean bursting pressure values of the groups that received 100 Hz, 1 or 2 mT PEMFs with 16-hour on/8-hour off cycles (90.88 +/- 19.13 and 83.88 +/- 7.08 mmHg, respectively) were significantly higher than those of the control group (61.66 +/- 10.6 mmHg) and the group with 6-hour on/6-hour off cycles (64.83 +/- 7.36 mmHg; P < 0.05 for all comparisons). Hydroxyproline contents of the anastomotic and perianastomotic segments were consistently higher in the 16-hour on/8-hour off PEMF groups, compared with those of the corresponding segments of the control group.
PEMFs applied externally to unrestrained rats within a "window of PEMF parameters" provided a significant gain in the mechanical strength of the colonic anastomosis, at least 72 hours post-operatively. Associated relative increases in the hydroxyproline contents of the (peri)anastomotic colonic segments suggest that an altered collagen metabolism might contribute to this enhancement of the anastomotic repair. Further investigations based on these preliminary data and the definition of the exact measures regarding the effects of PEMFs on biologic systems, in general, may lead to an efficient and new adjunctive modality in colorectal surgery.
本研究调查了脉冲电磁场（PEMFs）对大鼠单纯性结肠吻合口机械强度和胶原蛋白含量的影响。
在腹膜返折上方3 cm处进行标准化左半结肠切除术，用8针间断内翻缝合法进行端端吻合。术后立即开始，随机分组的大鼠暴露于以下条件之一：1）100 Hz（频率）、1 mT（强度）的PEMFs，开/关周期为16小时/8小时（n = 8）；2）100 Hz、2 mT的PEMFs，开/关周期为16小时/8小时（n = 8）；3）100 Hz、1 mT的PEMFs，开/关周期为6小时/6小时（n = 6），而对照组（n = 10）不接受PEMFs。术后72小时再次剖腹，原位记录吻合段的破裂压力。测定等长的吻合段和相邻吻合口周围段的羟脯氨酸含量。
接受100 Hz、1或2 mT的PEMFs且开/关周期为16小时/8小时的组的平均破裂压力值（分别为90.88±19.13和83.88±7.08 mmHg）显著高于对照组（61.66±10.6 mmHg）和开/关周期为6小时/6小时的组（64.83±7.36 mmHg；所有比较P < 0.05）。与对照组相应段相比，开/关周期为16小时/8小时的PEMF组的吻合段和吻合口周围段的羟脯氨酸含量始终较高。
在“PEMF参数窗口”内对未受限大鼠外部施加PEMFs，至少在术后72小时可显著提高结肠吻合口的机械强度。吻合口及吻合口周围结肠段羟脯氨酸含量的相关相对增加表明，胶原蛋白代谢改变可能有助于吻合口修复的增强。基于这些初步数据以及关于PEMFs对生物系统影响的确切措施的定义进行进一步研究，总体上可能会在结直肠手术中产生一种有效且新的辅助方式。
