The Effects of Ankaferd Blood Stopper on the Recovery Process in an Experimental Oesophageal Perforation Model

Yıl 2015, Cilt: 32 Sayı: 1, 96 - 100, 01.01.2015

Necla Gürbüz Sarıkaş Tanzer Korkmaz Nurettin Kahramansoy Ali Kılıçgün Çetin Boran Güledal Boztaş

Öz

Background: Oesophageal perforation is a life-threatening pathology that is generally treated conservatively; however, surgical procedures are frequently performed. A topical haemostatic agent, Ankaferd Blood Stopper (ABS), also has beneficial wound-healing effects. Aims: This study aimed to determine the effects of ABS following experimental oesophageal perforations. Study Design: Animal experiment. Methods: The experimental rats were classified into 6 groups (with 7 rats in each group). Pairs of groups (primary repair alone and primary repair + ABS) were terminated in the 1st, 2nd, and 3rd weeks following injury. The oesophageal perforations, which were 8-10 mm in length, were created using a nasogastric tube. The perforation sites were repaired with a 6-0 polyglactine thread in the primary repair groups. Additionally, ABS was sprayed over the perforation site in the treatment groups. Each oesophagus was evaluated histopathologically. Results: There were fewer microabscesses and areas of necrosis in the ABS groups compared with the primary repair groups. The histopathological evaluation revealed that the ABS groups had less inflammation and more re-epithelisation compared to the primary repair groups (p=0.002 and p=0.003, respectively). Fibrosis in the ABS groups was moderate in the 2nd week and mild in the 3rd week. Comparing the groups with respect to the time intervals, only the 1st week groups showed a significant difference in terms of re-epithelialisation (p=0.044). Conclusion: Topical ABS application on the repaired experimental oesophageal perforation regions led to positive wound-healing effects compared with the rats that were administered the primary repair alone.

Anahtar Kelimeler

Ankaferd Blood Stopper, experimental, oesophageal perforation

Kaynakça

• 1. Wu JT, Mattox KL, Wall MJ Jr. Esophageal perforations: new perspectives and treatment paradigms. J Trauma 2007;63:1173- 84. [CrossRef]
• 2. Kuppusamy MK, Hubka M, Felisky CD, Carrott P, Kline EM, Koehler RP, et al. Evolving management strategies in esophageal perforation: surgeons using nonoperative techniques to improve outcomes. J Am Coll Surg 2011;213:164-71. [CrossRef]
• 3. Okten I, Cangir AK, Ozdemir N, Kavukçu S, Akay H, Yavuzer S. Management of esophageal perforation. Surg Today 2001;31:36-9. [CrossRef]
• 4. Eroglu A, Turkyilmaz A, Aydin Y, Yekeler E, Karaoglanoglu N. Current management of esophageal perforation: 20 years experience. Dis Esophagus 2009;22:374-80. [CrossRef]
• 5. Martinez L, Rivas S, Hernández F, Avila LF, Lassaletta L, Murcia J, et al. Aggressive conservative treatment of esophageal perforations in children. J Pediatr Surg 2003;38:685-9. [CrossRef]
• 6. Sepesi B, Raymond DP, Peters JH. Esophageal perforation: surgical, endoscopic and medical management strategies. Curr Opin Gastroenterol 2010;26:379-83. [CrossRef]
• 7. Erdogan A, Gurses G, Keskin H, Demircan A. The sealing effect of a fibrin tissue patch on the esophageal perforation area in primary repair. World J Surg 2007;31:2199-2203. [CrossRef]
• 8. Demirbag S, Tiryaki T, Atabek C, Surer I, Ozturk H, Cetinkursun S. Conservative approach to the mediastinitis in childhood secondary to esophageal perforation. Clin Pediatr (Phila) 2005;44:131-4. [CrossRef]
• 9. Goker H, Haznedaroglu IC, Ercetin S, Kirazli S, Akman U, Ozturk Y, et al. Haemostatic actions of the folkloric medicinal plant extract Ankaferd Blood Stopper. J Int Med Res 2008;36:163-70. [CrossRef]
• 10. Bilgili H, Kosar A, Kurt M, Onal IK, Goker H, Captug O, et al. Hemostatic efficacy of Ankaferd Blood Stopper in a swine bleeding model. Med Princ Pract 2009;18:165-9. [CrossRef]
• 11. Tasdelen Fisgin N, Tanriverdi Cayci Y, Coban AY, Ozatli D, Tanyel E, Durupinar B, et al. Antimicrobial activity of plant extract Ankaferd Blood Stopper. Fitoterapia 2009;80:48-50. [CrossRef]
• 12. Saribas Z, Sener B, Haznedaroglu IC, Hascelik G, Kirazli Ş, Goker H. Antimicrobial activity of Ankaferd Blood Stopper against nosocomial bacterial pathogens. Cent Eur J Med 2010;5:198-202. [CrossRef]
• 13. Nageris BI, Zilker Z, Zilker M, Kariv N, Feinmesser R, Katzir A. Esophageal incisions repair by CO2 laser soldering. Otolaryngol Head Neck Surg 2004;131:856-9. [CrossRef]
• 14. Akbal E, Köklü S, Karaca G, Astarci HM, Koçak E, Taş A, et al. Beneficial effects of Ankaferd Blood Stopper on caustic esophageal injuries: an experimental model. Dis Esophagus 2012;25:188-94. [CrossRef]
• 15. Gander JW, Berdon WE, Cowles RA. Iatrogenic esophageal perforation in children. Pediatr Surg Int 2009;25:395-401. [CrossRef]
• 16. Leers JM, Vivaldi C, Schäfer H, Bludau M, Brabender J, Lurje G, et al. Endoscopic therapy for esophageal perforation or anastomotic leak with a self-expandable metallic stent. Surg Endosc 2009;23:2258-2262. [CrossRef]
• 17. Fischer A, Schrag HJ, Goos M, von Dobschuetz E, Hopt UT. Nonoperative treatment of four esophageal perforations with hemostatic clips. Dis Esophagus 2007;20:444-8. [CrossRef]
• 18. Freeman RK, Ascioti AJ, Giannini T, Mahidhara RJ. Analysis of unsuccessful esophageal stent placements for esophageal perforation, fistula, or anastomotic leak. Ann Thorac Surg 2012;94:959-65. [CrossRef]
• 19. D’Cunha J, Rueth NM, Groth SS, Maddaus MA, Andrade RS. Esophageal stents for anastomotic leaks and perforations. J Thorac Cardiovasc Surg 2011;142:39-46.e1.
• 20. Bleier BS, Gratton MA, Leibowitz JM, Palmer JN, Newman JG, Cohen NA. Laser-welded endoscopic endoluminal repair of iatrogenic esophageal perforation: an animal model. Otolaryngol Head Neck Surg 2008;139:713-7. [CrossRef]
• 21. Haznedaroglu BZ, Beyazit Y, Walker SL, Haznedaroglu IC. Pleiotropic cellular, hemostatic, and biological actions of Ankaferd hemostat. Crit Rev Oncol Hematol 2012;83:21-34. [CrossRef]