Stoop M J, Dirksen R, Wobbes T, Hendriks T
Department of Surgery, University Hospital Nijmegen, The Netherlands.
Br J Surg. 1998 Nov;85(11):1535-8. doi: 10.1046/j.1365-2168.1998.00868.x.
Results from a previous study suggested that advanced age does not affect early repair of experimental intestinal anastomoses. The present study aimed to establish whether anastomotic healing is impaired more easily in old animals by immediate postoperative chemotherapy.
Young adult (2-3 months) and old (27-30 months) rats underwent resection and anastomosis of both ileum and colon. Within each age group, subgroups received intraperitoneal saline or 5-fluorouracil in a dose of 15 or 20 mg per kg per day from the day of operation onwards. After 7 days, anastomotic healing was assessed by wound strength and collagen deposition in the wound area.
No differences were found between young and old control groups. The higher dose of fluorouracil induced severe loss of strength with concomitant reduction of wound collagen, which was similar in both age groups (ileum: from 52(13) to 24(8) volume per cent in young animals and from 56(10) to 20(9) volume per cent in old animals; colon: from 58(10) to 37(18) volume per cent in young animals and from 65(5) to 30(17) volume per cent in old animals). The lower dose of fluorouracil induced a significantly greater loss of strength, measured as the bursting pressure, in the old animals (150(49) versus 201(59) mmHg in colon of young rats).
In this model early anastomotic repair in older animals proceeds normally under optimal conditions, but it is more easily disturbed in the presence of fluorouracil.
先前一项研究的结果表明，高龄并不影响实验性肠吻合口的早期修复。本研究旨在确定术后立即进行化疗是否更容易损害老年动物的吻合口愈合。
对年轻成年（2 - 3个月）和老年（27 - 30个月）大鼠进行回肠和结肠切除及吻合术。在每个年龄组中，各亚组从手术当天起接受腹腔注射生理盐水或每天每千克15或20毫克的5-氟尿嘧啶。7天后，通过伤口强度和伤口区域的胶原沉积评估吻合口愈合情况。
年轻和老年对照组之间未发现差异。较高剂量的氟尿嘧啶导致强度严重丧失，同时伤口胶原蛋白减少，两个年龄组情况相似（回肠：年轻动物从52（13）体积百分比降至24（8）体积百分比，老年动物从56（10）体积百分比降至20（9）体积百分比；结肠：年轻动物从58（10）体积百分比降至37（18）体积百分比，老年动物从65（5）体积百分比降至30（17）体积百分比）。较低剂量的氟尿嘧啶导致老年动物以破裂压力衡量的强度损失显著更大（年轻大鼠结肠为150（49）mmHg，老年大鼠结肠为201（59）mmHg）。
在该模型中，老年动物的早期吻合口修复在最佳条件下正常进行，但在存在氟尿嘧啶的情况下更容易受到干扰。
