The healing of colon anastomosis covered with fibrin glue after early postoperative intraperitoneal chemotherapy

• Published in: Techniques in coloproctology 2006-06, Vol.10 (2), p.115-120
• Main Authors: Kanellos, I, Christoforidis, E, Kanellos, D, Pramateftakis, M G, Sakkas, L, Betsis, D
• Format: Article
• Language: English
• Subjects: Anastomosis, Surgical; Animals; Antimetabolites, Antineoplastic - administration & dosage; Antimetabolites, Antineoplastic - pharmacology; Colon - surgery; Fibrin Tissue Adhesive; Fluorouracil - administration & dosage; Fluorouracil - pharmacology; Injections, Intraperitoneal; Leucovorin - administration & dosage; Leucovorin - pharmacology; Male; Rats; Rats, Wistar; Vitamin B Complex - administration & dosage; Vitamin B Complex - pharmacology; Wound Healing - drug effects
• ISSN: 1123-6337; 1128-045X
• DOI: 10.1007/s10151-006-0263-4

After colon resection for colonic cancer, the administration of antineoplastic agents may prolong survival by killing residual cancer calls and preventing metastasis, but may also slow anastomotic healing. This study was designed to determine the effects of 5-fluorouracil (5-FU) and leucovorin (LEV), injected intraperitoneally, on the healing of colonic anastomoses with or without fibrin glue (FG) covering. Sixty rats were randomized to one of four groups. After resection of a transverse colon segment, an end-to-end sutured anastomosis was performed. Rats in the 5-FU+LEV and the 5- FU+LEV+FG groups received 5-FU+LEV intraperitoneally. The colonic anastomoses of the rats in the FG group and in the 5-FU+LEV+FG group were covered with fibrin glue. All rats were killed on postoperative day 8. Bursting pressure measurements were recorded and the anastomoses were examined macroscopically and histologically. The leakage rate of the anastomoses was significantly different among groups. Specifically, the leakage rate was significantly higher in the 5-FU+LEV group (40%) than in the FG and in the 5-FU+LEV+FG groups where there were no leakages (p=0.017). The mean adhesion formation score was significantly higher in rats of the 5-FU+LEV group, compared to the control (p=0.023), the FG (p=0.006) and the 5-FU+LEV+FG (p=0.006) groups. Bursting pressures were significantly lower in the 5-FU+LEV group than in the other groups (p