High-dose preoperative radiotherapy does not alter the strength of unilaterally irradiated colon anastomoses in rats.
OBJECTIVE
We studied the influence of preoperative radiotherapy on the strength of colon anastomoses in rats. We compared a conventional (2 Gy/fraction; 1 fraction/day; 5 days/week; cumulative doses of 40.0, 60.0, and 80.0 Gy) and a hyperfractionated schedule (1.6 Gy/fraction, 2 fractions/day, 5 days/week, cumulative doses of 41.6, 60.8, and 80.0 Gy). We compared unilaterally with bilaterally irradiated anastomoses for two conventional radiation schedules.


METHODS
The rectosigmoid was always irradiated. Depending on the experiment, the cecum was irradiated or not. A side-to-side anastomosis between rectosigmoid and cecum was constructed the day following the last irradiation. The strength of the anastomosis was evaluated by means of a bursting pressure (BP) measurement after 10 days. A control group and a sham-treated group were carried out.


RESULTS
Compared to controls, the strength of unilaterally irradiated anastomoses was not altered and BP values were independent of the radiation schedule and of the cumulative dose. In case of bilaterally irradiated colon anastomoses, anastomotic strength was significantly reduced at 80 Gy, but not at 40 Gy.


CONCLUSIONS
After high doses of preoperative radiotherapy, colon anastomoses in rats can be safely constructed if only one anastomotic segment is irradiated. The strength of bilaterally irradiated colon anastomoses is dose-dependent.
De Meerleer
G
G
Division of Radiotherapy, University of Gent, University Hospital, Belgium.
Pattyn
P
P
Fortan
L
L
De Wever
N
N
Cuvelier
C
C
Van Renterghem
K
K
Berrevoet
F
F
De Neve
W
W
D000714:Anastomosis, Surgical; D000818:Animals; D002432:Cecum / Q000528:radiation effects* / Q000601:surgery*; D003106:Colon / Q000528:radiation effects* / Q000601:surgery*; D012809:Colon, Sigmoid / Q000528:radiation effects / Q000601:surgery; D008297:Male; D011829:Radiation Dosage; D011853:Radiobiology; D051381:Rats; D017208:Rats, Wistar; D013718:Tensile Strength / Q000528:radiation effects