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Abstract

Backgrounds: Thyroid hormones play a critical developmental and regulatory role on the morphology and biochemistry of gastrointestinal mucosal cells and wound healing. The aim of this study is to determine the effect of L-Thyroxin on colonic anastomosis healing. Method: Thirty male Wistar Albino rats were equally divided (n=10) in to three groups. Group 1 was the sham group whereas groups 2 and 3 were made hypothyroid by administration of propylthiouracil 10mg/kg/day per oral for four weeks. Hypothyrodism was confirmed with measurement of free-T3 and free T4 levels. All groups were subjected to left colonic transection and anastomosis. Group 3 rats have taken L-thyroxin therapy intraperitoneally 5g in 1cc saline daily for seven days. Anastomosis bursting pressure, hydroxyproline and IGF-I Ab-1 measurements were done on postoperative 7th day. Results: The anastomosis bursting pressure levels of group 3 were significantly higher than both group1 (p=0,03) and group2 (p=0,002). Hydroxyproline levels were significantly higher in group 3 than both group1 and group 2 (Group3 versus group1 p=0,003 and group 3 versus group 2 p=0,002). The IGF-1 Ab-1 staining integrity were higher in group3 versus group1 (P=0,008) and group2 (P=0,005) respectively. Conclusions: Thyroid hormones improve anastomosis healing as documented increased hydroxiproline levels and anastomotic bursting pressure

Keywords

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L-Tiroksinin Insulin Like Growth Factor–I İle Etkileşimi İle Kolon Anastomozu İyileşmesine Üzerindeki Etkisi

Abstract

Amaç: Tiroid hormonları yara iyileşmesinde ve gastrointestinal mukozal hücrelerinin biyokimya ve morfolojisinde düzenleyici ve gelişimsel bir rol oynarlar. Bu çalışmanın amacı L-Tiroksinin kolon anastomozu iyileşmesine etkisini belirlemektir. Yöntem: Otuz adet erkek Wistar-Albino sıçan eşit olarak üç gruba ayrıldı. Grup-1 sham grubu iken grup-2 ve grup-3, 10mg/kg/gün propiltiyoürasil verilerek hipotiroid yapılmış hayvanlardan oluşmakta idi. Hipotiroidi serbest T3 ve T4 ölçülerek kesinleştirildi. Bütün gruplara sol kolonik transeksiyon ve anastomoz yapıldı. Grup-3’teki ratlara L-tiroksin intraperitoneal olarak 5 g, 1 cc izotonik içinde yedi gün verildi. Postoperatif yedinci günde anastomoz patlama basınçları, hidroksipirolin düzeyleri, IGF-I Ab-1 ölçümleri yapıldı. Bulgular: Grup-3’ün anastomoz patlama basınçları grup-1 (p=0,03) ve grup-2’den (p=0,002) belirgin olarak yüksek idi. Hidroksiprolin düzeyleri grup-3’de grup-1ve grup-2’den anlamlı yüksek izlendi (Grup3 ile Grup-1 p=0,003; grup-3 ile grup-2 p=0,002). IGF-1 Ab-1 boyanma oranı grup-1 (p=0,008) ve grup-2’ye (p=0,005) göre grup 3’te daha yüksek bulundu Sonuç: Yüksek anastomoz patlama basınçları ve hidroksipirolin düzeyleri ile gösterildiği üzere tiroid hormonu verilmesi kolon anastomozunun iyileşmesini olumlu etkilemektedir

Keywords

• Hipotiroidi, L-Tiroksin, Kolon Anastomoz

References

1. Moertel CG, Fleming TR, Macdonald JS, et all. Fluorouracil plus levamisole as effective adjuvant therapy after resection of stage III colon carcinoma: A final report. Ann Intern Med 1995;122(5):321-6.
2. Jiborn H, Ahonen J, Zederfeldt B. Healing of experimental colonic anastomosis. I. Bursting strength of the colon after left colon resection and anastomosis. Am J Surg 1978;136(5):587-94.
3. Hernandez DE, Walker CH, Mason GA. Influence of thyroid states on stress gastric ulcer formation. Life Sci 1988; 42(18):1757-64.
4. Lennox J, Johnston ID. The effect of thyroid status on nitrogen balance and the rate of wound healing after injury in rats. Br J Surg 1973; 60(4):309.
5. Verhofstad MHJ, Langr WP, van der Laak JAWM, Verhofstad AAJ, Hendriks T. Microscopic analysis of anastomotic healing in the intestine of normal and diabetic rats. Dis Col Rec 2001; 44(3):423-31.
6. Reddy GK, Enwemeka CS. A simplified method for the analysis of hydroxyproline in biological tissues. Clin Biochem 1996; 29(3):225-9.
7. Morgenstren L, Yamakawa T, Ben-Shoshan M, Lippman H. Anastomotic leakage after low colonic anastomosis. Am J Surg 1972; 123(1):104-9.
8. Demirer S, Sengul N, Inan A, Eroglu A, Bumin C, Kuterdem E. Effect of recombinant human granulocyte/macrophage colony-stimulating factor on the healing of colonic anastomosis in rats. J Invest Surg 2001; 14(4):221-5.

9. Fukuchi SG, Seeburger JL, Parquet G, Rolandelli RH. Influence of 5-Fluorouracil on Colonic Healing and Expression of Transforming Growth Factor-Beta 1. J Surg Res 1999: 84(2):121-6.
10. Jiborn H, Ahonen J, Zederfeldt B. Healing of experimental colonic anastomosiss. III. Collagen metabolism in the colon after left colon resection. Am J Surg 1980; 139(3):398-405.
11. Zuidewijn DBW de Roy van, Hendriks T, Wobbes T, de Boer HHM. Cytostatics and anastomotic healing in the intestine: an experimental study on the effect of parenteral nutrition. Eur Surg Res 1992;24(2):103-11.
12. Hervas FG, Morreale de Escobar F, Escobar del Rey. Rapid effects of single small dose of L-Throxine and triiyodo-L-thyroxine on growth hormone as studied in the rat by radioimmunoassay. Endocrinology 1975: 97(1):91-101.
13. Coiro V, Braverman LE, Christianson D, Fang SL, Goodman HM. Effect of hypothyrodism and thyroxine replacement on growth in the rat. Endocrinology 1979; 105(3):641-6.
14. Froesch ER, Schmid C, Schwander J, Zapf J. Action of insulin-like growth factors. Annu Rev Physiol 1985;47:433-67.
15. Dieguez C, Page MD, Scanlon MF. Growth hormone neuroregulation and its alterations in disease states. Clin Endoc 1988; 28(1):109-43.
16. Melmed S, Yamashita S. Insulin-like growth factor I action on hypothyroid rat and pituitary cells; suppression of triiyodothyronine-induced growth hormone secretion and messenger ribonucleic acid levels. Endocrinology 1986; 118(4):1483-90.
17. Tarkkinen P, Hagren V, Palenius T, Lovgren T. One-step quantitative thyrotropin assay for the detection of hypothyroidism in point-of-care conditions. Clin Biochem 2003;36(2):121-8.
18. Bergeron E, Mitchell A, Heyen F, Dube S. Acute colonic surgery and unrecognized hypothyroidism: a warning. Report of six cases. Dis Col Rec 1997: 40(7):859-61.