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The effects of non-steroid anti-inflammatory drugs on healing of colonic anastomosis in rats

Year 2008, Volume: 13 Issue: 1-2, 13 - 18, 14.01.2013

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, rats

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.
  • Hendriks T, Vereecken TH, Hesp WL, et al. Loss of collagen from experimental intestinal anastomoses: early events. Exp Mol Pathol 1985; : 411-418.
  • Peacock EE, van Winkle W. The biochemistry and the environment of wounds and their relation to wound strength. In: Peacock EE, van Winkle W, eds. Wound Repair, 2nd ed. Philadelphia: WB Saunders, 1976, pp 145-203.
  • Mastboom WJB, Hendriks T, van Elteren P, et al. The influence of NSAIDs onexperimental intestinal anastomoses. Dis Colon Rectum 1991;34:236-243.
  • Beck A, Krischak G, Sorg T, et al. Influence of diclofenac (group of nonsteroidal anti- inflammatory drugs) on fracture healing. Arch Orthop Trauma Surg 2003; 123: 327-332.
  • Oxlund H, Cristensen H, Seyer-Hensen M, Andreassen TT. Collagen deposition and mechanical strength of colon anastomoses and skin incisional wounds of rats. J Surg Res 1996; 66: 25
  • Jiborn H, Abonen J, Zederfeldt B. Healing of experimental colonic anastomoses. III. Collagen metabolism in the colon after left colon resection. Amer J Surg 1980; 139: 398-405.
  • Brasken P, Renvall S, Sandberg M. Fibronectin and collagen gene expression in healing experimental colonic anastomoses. Br J Surg 1991; 78: 1048
  • Martens MF, Hendriks T. Postoperative changes in collagen synthesis in intestinal anastomoses of the rat: differences between small and large bowel. Gut ; 32: 1482-1487.
  • Angelis-Stoforidis P, Vajda FJ, Christophidis N. Effects of non-steroidal anti-inflammatory drugs (NSAIDs) on human polymorphonuclear leucocyte function in buffer and plasma. Clin Exp Rheumatol ; 16: 703-708. Hirasawa N, Ohuchi K, Watanabe M, et al. Mechanism of the inhibitory action of cyclooxygenase inhibitors on leukocyte infiltration: involvement of endogenous histamine. Eur J Pharmacol 1987; 144: 267-275.
  • Blomme EAG, Chinn KS, Hardy MM, et al. Selective cyclooxygenase-2 inhibition does not affect the healing of cutaneous full-thickness incisional wounds in SKH-1 mice. Br J Dermatol ; 148: 211-223. Hendriks JM, Hubens G, Wuyts FL, et al. Experimental study of intraperitoneal suramin on the healing of colonic anastomoses. Br J Surg ; 86: 1171-1175.
  • De Sousa JB, Soares EG, Aprilli F. Effects of diclofenac sodium on intestinal anastomotic healing. Experimental study on the small intestine of rats. Dis Colon Rectum 1991; 34: 613-617.
  • Brennan SS, Foster ME, Morgan A, et al. Prostaglandins in colonic anastomotic healing. Dis Colon Rectum 1984; 27: 723-725.
  • Uzunköy A, Akıncı OF, Coşkun A, et al. Effects of antiadhesive agents on the healing of intestinal anastomosis. Dis Colon Rectum 2000; 43: 370-375.
Year 2008, Volume: 13 Issue: 1-2, 13 - 18, 14.01.2013

Abstract

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.
  • Hendriks T, Vereecken TH, Hesp WL, et al. Loss of collagen from experimental intestinal anastomoses: early events. Exp Mol Pathol 1985; : 411-418.
  • Peacock EE, van Winkle W. The biochemistry and the environment of wounds and their relation to wound strength. In: Peacock EE, van Winkle W, eds. Wound Repair, 2nd ed. Philadelphia: WB Saunders, 1976, pp 145-203.
  • Mastboom WJB, Hendriks T, van Elteren P, et al. The influence of NSAIDs onexperimental intestinal anastomoses. Dis Colon Rectum 1991;34:236-243.
  • Beck A, Krischak G, Sorg T, et al. Influence of diclofenac (group of nonsteroidal anti- inflammatory drugs) on fracture healing. Arch Orthop Trauma Surg 2003; 123: 327-332.
  • Oxlund H, Cristensen H, Seyer-Hensen M, Andreassen TT. Collagen deposition and mechanical strength of colon anastomoses and skin incisional wounds of rats. J Surg Res 1996; 66: 25
  • Jiborn H, Abonen J, Zederfeldt B. Healing of experimental colonic anastomoses. III. Collagen metabolism in the colon after left colon resection. Amer J Surg 1980; 139: 398-405.
  • Brasken P, Renvall S, Sandberg M. Fibronectin and collagen gene expression in healing experimental colonic anastomoses. Br J Surg 1991; 78: 1048
  • Martens MF, Hendriks T. Postoperative changes in collagen synthesis in intestinal anastomoses of the rat: differences between small and large bowel. Gut ; 32: 1482-1487.
  • Angelis-Stoforidis P, Vajda FJ, Christophidis N. Effects of non-steroidal anti-inflammatory drugs (NSAIDs) on human polymorphonuclear leucocyte function in buffer and plasma. Clin Exp Rheumatol ; 16: 703-708. Hirasawa N, Ohuchi K, Watanabe M, et al. Mechanism of the inhibitory action of cyclooxygenase inhibitors on leukocyte infiltration: involvement of endogenous histamine. Eur J Pharmacol 1987; 144: 267-275.
  • Blomme EAG, Chinn KS, Hardy MM, et al. Selective cyclooxygenase-2 inhibition does not affect the healing of cutaneous full-thickness incisional wounds in SKH-1 mice. Br J Dermatol ; 148: 211-223. Hendriks JM, Hubens G, Wuyts FL, et al. Experimental study of intraperitoneal suramin on the healing of colonic anastomoses. Br J Surg ; 86: 1171-1175.
  • De Sousa JB, Soares EG, Aprilli F. Effects of diclofenac sodium on intestinal anastomotic healing. Experimental study on the small intestine of rats. Dis Colon Rectum 1991; 34: 613-617.
  • Brennan SS, Foster ME, Morgan A, et al. Prostaglandins in colonic anastomotic healing. Dis Colon Rectum 1984; 27: 723-725.
  • Uzunköy A, Akıncı OF, Coşkun A, et al. Effects of antiadhesive agents on the healing of intestinal anastomosis. Dis Colon Rectum 2000; 43: 370-375.
There are 21 citations in total.

Details

Primary Language English
Journal Section Articles
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
Published in Issue Year 2008 Volume: 13 Issue: 1-2

Cite

APA Esen, E., Sucullu, İ., Sinan, H., Küçükodacı, Z., et al. (2013). The effects of non-steroid anti-inflammatory drugs on healing of colonic anastomosis in rats. EASTERN JOURNAL OF MEDICINE, 13(1-2), 13-18.
AMA Esen E, Sucullu İ, Sinan H, Küçükodacı Z, Filiz Aİ, Yucel E, Akın ML. The effects of non-steroid anti-inflammatory drugs on healing of colonic anastomosis in rats. EASTERN JOURNAL OF MEDICINE. March 2013;13(1-2):13-18.
Chicago Esen, Ersoy, İlker Sucullu, Huseyin Sinan, Zafer Küçükodacı, Ali İlker Filiz, Ergun Yucel, and Mehmet Levhi Akın. “The Effects of Non-Steroid Anti-Inflammatory Drugs on Healing of Colonic Anastomosis in Rats”. EASTERN JOURNAL OF MEDICINE 13, no. 1-2 (March 2013): 13-18.
EndNote Esen E, Sucullu İ, Sinan H, Küçükodacı Z, Filiz Aİ, Yucel E, Akın ML (March 1, 2013) The effects of non-steroid anti-inflammatory drugs on healing of colonic anastomosis in rats. EASTERN JOURNAL OF MEDICINE 13 1-2 13–18.
IEEE E. Esen, İ. Sucullu, H. Sinan, Z. Küçükodacı, A. İ. Filiz, E. Yucel, and M. L. Akın, “The effects of non-steroid anti-inflammatory drugs on healing of colonic anastomosis in rats”, EASTERN JOURNAL OF MEDICINE, vol. 13, no. 1-2, pp. 13–18, 2013.
ISNAD Esen, Ersoy et al. “The Effects of Non-Steroid Anti-Inflammatory Drugs on Healing of Colonic Anastomosis in Rats”. EASTERN JOURNAL OF MEDICINE 13/1-2 (March 2013), 13-18.
JAMA Esen E, Sucullu İ, Sinan H, Küçükodacı Z, Filiz Aİ, Yucel E, Akın ML. The effects of non-steroid anti-inflammatory drugs on healing of colonic anastomosis in rats. EASTERN JOURNAL OF MEDICINE. 2013;13:13–18.
MLA Esen, Ersoy et al. “The Effects of Non-Steroid Anti-Inflammatory Drugs on Healing of Colonic Anastomosis in Rats”. EASTERN JOURNAL OF MEDICINE, vol. 13, no. 1-2, 2013, pp. 13-18.
Vancouver Esen E, Sucullu İ, Sinan H, Küçükodacı Z, Filiz Aİ, Yucel E, Akın ML. The effects of non-steroid anti-inflammatory drugs on healing of colonic anastomosis in rats. EASTERN JOURNAL OF MEDICINE. 2013;13(1-2):13-8.