title: Post-operative levamisole may compromise early healing of experimental intestinal anastomoses.
abstract: There exists growing interest in immediate post-operative local adjuvant therapy after resection of intestinal malignancies. It is therefore necessary to assess it potential effect on the healing of intestinal anastomoses. Five groups (n = 20) of rats underwent resection and anastomosis of both ileum and colon: a control group and four experimental groups receiving intraperitoneal 5-fluorouracil (5-FU), 5-FU plus leucovorin, 5-FU plus levamisole or levamisole alone, on the day of surgery and the next 2 days. Animals were killed 3 or 7 days after operation. Another three groups (n = 6) of animals were used to compare anastomotic collagen synthetic capacity in control rats or rats receiving 5-FU or 5-FU plus levamisole. On the third post-operative day, the average anastomotic bursting pressure in the 5-FU/levamisole group was reduced by 36% as compared with the control group, both in ileum (P = 0.02) and in colon (P = 0.01). Values in the other groups were similar to those in the control group. Anastomotic breaking strength was significantly (P < 0.025) lowered in the ileum from the levamisole group at both days 3 and 7. Anastomotic collagen synthetic capacity was strongly reduced in the 5-FU and 5-FU/levamisole groups. However, there was no significant difference between the control group and the four experimental groups with regard to anastomotic hydroxyproline concentration and content, either 3 or 7 days after operation. Thus, limited use of levamisole, alone or in combination with intraperitoneal 5-FU, may compromise intestinal healing.
authors.affiliation: Department of Surgery, University Hospital Nijmegen, The Netherlands.
authors.forename: J W
authors.initials: JW
authors.lastname: de Waard
authors.forename: T
authors.initials: T
authors.lastname: Wobbes
authors.forename: B M
authors.initials: BM
authors.lastname: de Man
authors.forename: C J
authors.initials: CJ
authors.lastname: van der Linden
authors.forename: T
authors.initials: T
authors.lastname: Hendriks
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D003094:Collagen / Q000096:biosynthesis; D005472:Fluorouracil / Q000009:adverse effects / Q000494:pharmacology; D006909:Hydroxyproline / Q000032:analysis; D007422:Intestines / Q000601:surgery*; D002955:Leucovorin / Q000009:adverse effects; D007978:Levamisole / Q000009:adverse effects*; D008297:Male; D011182:Postoperative Care / Q000009:adverse effects*; D011312:Pressure; D051381:Rats; D017208:Rats, Wistar; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D007978:Levamisole; D003094:Collagen; D002955:Leucovorin; D006909:Hydroxyproline; D005472:Fluorouracil