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

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)...

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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
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container_title Techniques in coloproctology
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Christoforidis, E
Kanellos, D
Pramateftakis, M G
Sakkas, L
Betsis, D
description 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
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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&lt;0.001). Also, bursting pressures were significantly lower in the control group compared to the FG and 5-FU+LEV+FG groups (p&lt;0.001). Rats in the 5-FU+LEV+FG group had significantly greater neoangiogenesis and fibroblast activity than those in the 5-FU+LEV group (p=0.025). The early intraperitoneal postoperative administration of 5-fluorouracil plus leucovorin impaired colonic wound healing. 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ispartof Techniques in coloproctology, 2006-06, Vol.10 (2), p.115-120
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1128-045X
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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
title The healing of colon anastomosis covered with fibrin glue after early postoperative intraperitoneal chemotherapy
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