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. 2020 Jun 30;9(2):e129.
doi: 10.15190/d.2021.8. eCollection 2021 Apr-Jun.

Healing of colonic anastomosis in rats under obstructive ileus conditions

Affiliations

Healing of colonic anastomosis in rats under obstructive ileus conditions

Kalliopi Despoudi et al. Discoveries (Craiova). .

Abstract

Background: The anastomosis leak in colon resections is a crucial post-operative complication with significant morbidity and mortality. Methods: Forty (40) Wistar rats were allocated in two groups. In SHAM group only anastomosis was performed. In ILEUS group anastomosis was performed following one day of ileus. Animals in both groups were subdivided in two groups according to the day they were sacrificed, 4th or 8th post-operative day. A number of variables between the groups were estimated.

Results: Body weight loss was higher following obstructive ileus on both days. Adhesion score in 4th and 8th post-operative day was higher in ILEUS1, ILEUS2 groups compared to SHAM1, SHAM2 groups respectively (p<0.001 for both). Neovascularization decreased following obstructive ileus compared to control on the 4th day (ILEUS1 vs. SHAM1, p=0.038). Bursting pressure was lower in ILEUS2 group than SHAM2 group (p<0.001). The number of fibroblasts decreased following obstructive ileus compared to control on the 4th and 8th day (ILEUS1 vs. SHAM1, p=0.001, ILEUS2 vs SHAM2, p=0.016). Hydroxyproline concentration was decreased in ILEUS2 group compared to SHAM2 group (p<0.001).

Conclusions: The balance of collagenolysis and collagenogenesis plays a decisive role in the healing of anastomoses following bowel obstruction. Under those circumstances, anastomosis' bursting pressure is reduced owning to decreased neovascularization, reduced fibroblast presence and lower hydroxyproline concertation. In our study, local inflammation, neocollagen concentration and collagenase activity were not associated with this adverse effect. However, further research should delineate the mechanisms of healing of colonic anastomoses and identify those factors that can improve our outcomes.

Keywords: Anastomosis; bursting pressure; collagen.; ileus; leak.

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Conflict of interest statement

Conflict of interests: The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1. Comparative bar chart of body weight
Statistically significant difference in body weight in both 4th and 8th post-operative day was noted in ILEUS group. In addition, body weight in ILEUS2 subgroup was statistically significant lower compared to ILEUS1 subgroup after the intervention.
Figure 2
Figure 2. Comparative bar chart of body weight changes
In ILEUS subgroup, there was a statistically significant increase in body weight changes from the fourth to the eighth day. In addition, weight changes in SHAM2 subgroup was decreased in comparison to ILEUS2 subgroup and SHAM1 in comparison to ILEUS1.
Figure 3
Figure 3. Comparative bar chart of adhesion formation (mean)
The adhesion formation score was statistically significantly higher in both ILEUS subgroups compared to SHAM.
Figure 4
Figure 4. Comparative bar chart presenting bursting pressures (mmHg) (mean ± standard deviation)
A statistically significant increase in the bursting pressure was noted on the eighth postoperative day in the SHAM2 subgroup compared to the ILEUS2 and SHAM1 subgroups.
Figure 5
Figure 5. Comparative bar chart presenting the average inflammatory cell infiltration, according to the scale of Ehrlich and Hunt, as modified by Philips et al. (mean ± standard deviation)
Increased leucocytosis in ILEUS1 subgroup compared to ILEUS2 subgroup was noted. In addition, increased leucocytosis was noted in SHAM1 group compared to SHAM2 group.
Figure 6
Figure 6. Comparative bar chart presenting the average new vessel formation (neoangiogenesis), according to the scale of Ehrlich and Hunt, as modified by Philips et al. (0–4) (mean ± standard deviation)
The average neoangiogenesis was statistically significantly increased in ILEUS2 subgroup compared to ILEUS1 subgroup. In addition, increased neovascularization was noted in SHAM2 group compared to SHAM1 group. Furthermore, augmented neoangiogenesis was revealed in SHAM1 group compared to ILEUS1 group.
Figure 7
Figure 7. Comparative bar chart presenting the average fibroblast activity, according to the scale of Ehrlich and Hunt, as modified by Philips et al. (0–4) (mean ± standard deviation)
The average fibroblast activity was statistically significantly higher in ILEUS2 subgroup compared to ILEUS1 subgroup. In addition, increased fibroblast activity was noted in SHAM2 group compared to SHAM1 group. Furthermore, augmented fibroblast activity was revealed in SHAM1 group compared to ILEUS1 group SHAM2 group compared to ILEUS2 group.
Figure 8
Figure 8. Comparative bar chart presenting the average collagen deposition, according to the scale of Ehrlich and Hunt, as modified by Philips et al. (0–4) (mean ± standard deviation)
The average collagen deposition was statistically significantly higher in each subgroup in collagen deposition from the fourth to the eighth day.
Figure 9
Figure 9. Comparative bar chart of hydroxyproline tissue contents (μg/g tissue) at the anastomotic site (mean ± standard deviation)
In SHAM subgroup, there was a statistically significant increase in hydroxyproline tissue content from the fourth to the eighth day. In addition, hydroxyproline tissue contents at the anastomotic site in SHAM2 subgroup was increased in comparison to ILEUS2 subgroup.
Figure 10
Figure 10. Comparative bar chart of collagenase I tissue contents (μg/g tissue) at the anastomotic site (mean ± Standard deviation)
No statistically significant difference was noted.

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References

    1. Progress in rectal cancer staging and treatment. Pramateftakis M G, Kanellos D, Vrakas G, Tsachalis Tau, Raptis D, Makrantonakis A, Koukouritaki Z, Kanellos I. Techniques in coloproctology. 2010;14 Suppl 1:S29–31. - PubMed
    1. Anastomotic leakage following anterior resection for rectal cancer. Kanellos I, Vasiliadis K, Angelopoulos S, Tsachalis T, Pramateftakis M G, Mantzoros I, Betsis D. Techniques in coloproctology. 2004;8 Suppl 1:s79–81. - PubMed
    1. Oncologic impact of anastomotic leakage after low anterior resection for rectal cancer. Mantzoros I. Techniques in coloproctology. 2010;14 Suppl 1:S39–41. - PubMed
    1. Anastomotic leakage after colonic resection. Kanellos D. Techniques in coloproctology. 2010;14 Suppl 1:S43–4. - PubMed
    1. Parameters of healing in approximative intestinal anastomosis. Rygl M, Novotna J, Herget J, Skaba R, Snajdauf J. European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie. 2009;19(1):25–9. - PubMed

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