The effect of chemotherapy with 5-fluorouracil, bleomycin and cisplatin in the healing of colonic anastomoses in rats.

Abstract:

PURPOSE:Chemotherapeutic factors are known to affect healing on the postoperative patient. The aim of the present experimental study was to evaluate the effect of intraperitoneal infusion of 5-fluorouracil, bleomycin and cisplatin on the healing of colonic anastomoses in rats. METHODS:Forty Albino-Wistar male rats were randomly divided into two groups, a control and a chemotherapy (CT) group. In both, an end-to-end colonic anastomosis was performed. collagen, In the control group, 2cc saline was administered intraperitoneally during the operation and daily postoperatively until the sacrifice. In the CT group, rats were administered a solution of 5-fluorouracil (20mg/kg b.w.), bleomycin (4mg/kg b.w.) and cisplatin (0.7 mg/kg b.w.) in an amount of 2cc intraperitoneal intraoperatively and afterwards daily postoperatively until the seventh postoperative day when they were sacrificed. At sacrifice, adhesion presence was calculated and the anastomoses were resected and macroscopically examined. Bursting pressures were calculated and histological features were graded. Hydroxyproline concentrations were evaluated. RESULTS:No deaths or wound infections were observed until sacrifice. Bodyweight was significantly decreased in the CT group (p=0.005). Bursting pressures (p=0.001) were significantly lower in the chemotherapy group, whereas adhesions were significantly increased (p=0.001). Hydroxyproline concentrations were not significantly different (p=0.401). All histological parameters appeared significantly decreased in the CT group: inflammation (p<0.008), neoangiogenesis (p<0.001), and fibroblast activity (p=0.001) and collagen deposition (p<0.001). CONCLUSION:The use of chemotherapeutic agents had negative effects on the healing process of colonic anastomosis in rats. The decreased inflammatory response depicts in more frequent anastomotic dehiscence, ruptures and bodyweight loss postoperatively. KEY WORDS:Adhesion, Bursting pressure, Collagen, Hydroxyproline, Inflammation, Neoangiogenesis. :È noto che i fattori chemioterapici influenzano la guarigione del paziente postoperatorio. Lo scopo del presente studio sperimentale era di valutare l’effetto dell’infusione intraperitoneale di 5-fluorouracile, bleomicina e cisplatino sulla guarigione delle anastomosi del colon nei ratti. METODI: Quaranta ratti maschi Albino-Wistar sono stati divisi casualmente in due gruppi, un gruppo di controllo e un gruppo di chemioterapia (CT). In entrambi, è stata eseguita un’anastomosi del colon end-to-end. Nel gruppo di controllo, sono stati somministrati per via intraperitoneale durante l’operazione 2cc di una soluzione salina, e poi quotidianamente dopo l’intervento fino al sacrificio degli animali. Nel gruppo CT, sono stati somministrati per via intraperitoneale durante l’operazione 2cc di una soluzione con 20 mg/ kg di peso corporeo di 5-fluorouracile, 4 mg/kg di peso corporeo di bleomicina e 0,7 mg/kg di peso corporeo di cisplatino, e successivamente quotidianamente dopo l’intervento fino al settimo giorno postoperatorio in cui furono sacrificati. Al sacrificio, è stata calcolata la presenza di aderenze e le anastomosi sono state resecate ed esaminate macroscopicamente. Sono state calcolate le pressioni di scoppio e sono state classificate le caratteristiche istologiche. Sono state valutate le concentrazioni di idrossiprolina. RISULTATI: nessuna morte o infezione della ferita è stata osservata fino al sacrificio. Il peso corporeo è stato significativamente ridotto nel gruppo CT (p = 0,005). Le pressioni di scoppio (p = 0,001) erano significativamente più basse nel gruppo chemioterapico, mentre le aderenze erano significativamente aumentate (p = 0,001). Le concentrazioni di idrossiprolina non erano significativamente diverse (p = 0,401). Tutti i parametri istologici sono apparsi significativamente diminuiti nel gruppo CT: infiammazione (p <0,008), neoangiogenesi (p <0,001) e attività dei fibroblasti (p = 0,001) e deposizione di collagene (p <0,001). CONCLUSIONE: L’uso di agenti chemioterapici ha influito negativamente sul processo di guarigione dell’anastomosi del colon nei ratti. La diminuzione della risposta infiammatoria indica un più frequente rischio di deiscenza anastomotica, di rotture e perdita di peso corporeo dopo l’intervento.

journal_name

Ann Ital Chir

authors

Lambrou I,Mantzoros I,Ioannidis O,Tatsis D,Chasampalioti M,Bitsianis S,Pramateftakis MG,Kotidis E,Ouzounidis N,Angelopoulos S,Dimitriadis C,Tsalis K

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

552-562

eissn

0003-469X

issn

2239-253X

pii

S0003469X20033862

journal_volume

91

pub_type

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