The effects of non-steroid anti-inflammatory drugs on healing of colonic anastomosis in rats
Abstract
Abstract. NSAIDs have dual roles of providing analgesia and promoting healing. This study investigated the effects of 3 different NSAIDs on healing of colonic anastomosis in rats. The aim is to provide an evidence-based rationale for choice of postoperative analgesic agent in surgical patients who undergo this procedure. Forty-eight Sprague-Dawley conventional rats were separated into 4 groups of 12 rats, with one group as control, and the other groups receiving tenoxicam, metamizole, or diclofenac, respectively. Each group was subdivided into 2 subgroups according to sacrifice on postoperative day 3 or 7. Anastomotic healing was assessed by 3 parameters: (1) physical evaluation (bursting pressure), (2) histological evaluation (fibrotic index), and (3) biochemical evaluation (tissue hydroxyproline levels). Diclofenac had a negative effect on bursting pressures. Tenoxicam significantly increased the fibrotic index at day 7. Metamizole increased tissue hydroxyproline levels at day 3, but there was no significant difference between control and NSAID groups at day 7. Each drug showed benefits and drawbacks. Because tenoxicam promoted fibrosis, and metamizole increased collagen synthesis, with both agents showing few disadvantages, these 2 agents are recommended above diclofenac for promoting healing.
Key words: NSAID, Colonic anastomoses, ratsKeywords
References
- Hendriks T, Mastboom WJ. Healing of experimental intestinal anastomoses. Dis Colon Rectum 1990; 33: 891-901.
- Buchs NC, Gervaz P, Secic M, et al. Incidence, consequences, and risk factors for anastomotic dehiscence after colorectal surgery: a prospective monocentric study. Int J Colorectal Dis 2007; 23: 270.
- Kiyama T, Onda M, Tokunaga et al. Effect of matrix metalloproteinase inhibition on colonic anastomotic healing in rats. J Gastrointest Surg ; 5: 303-311. Sucullu I, Sinan H, Filiz AI, et al. The effects of hyperbaric oxygen therapy on colonic anastomosis in rats with peritonitis. J Investigative Surg 2008; : 195-200.
- Inan A, Koca C, Sen M. Effects of diclofenac sodium on bursting pressures of anastomoses and hydroxyproline contents of perianastomotic tissues in a laboratory study. Int J Surg 2006; 4: 222-227.
- Chowcat NL, Savage FJ, Lewin MR, et al. Direct measurement of collagenase in colonic anastomosis. Br J Surg 1990; 77: 1284-1287.
- Savage FJ, Lacombe DL, Hembry RM, et al. Effect of colonic obstruction on the distribution of matrix metalloproteinases during anastomotic healing. Br J Surg 1998; 85: 72-75.
- Gabella G. The cross-ply arrangement of collagen fibres in the submucosa of the mammalian small intestine. Cell Tissue Res 1987; 248: 491-497.
- Hunt TK, Hawley PR, Hale J, et al. Colon repair: the collagenous equilibrium. In Hunt TK, ed. Wound Healing and Wound Infection. New York: Appleton-Century-Crofts, 1980, pp 153-159.
Details
Primary Language
English
Subjects
-
Journal Section
-
Authors
Ersoy Esen
This is me
İlker Sucullu
This is me
Huseyin Sinan
This is me
Zafer Küçükodacı
This is me
Ali İlker Filiz
This is me
Ergun Yucel
This is me
Mehmet Levhi Akın
This is me
Publication Date
January 14, 2013
Submission Date
January 14, 2013
Acceptance Date
-
Published in Issue
Year 2008 Volume: 13 Number: 1-2