title: Antithrombin III prevents deleterious effects of remote ischemia-reperfusion injury on healing of colonic anastomoses.
abstract: BACKGROUND
  Antithrombin III is known as the most important natural inhibitor of thrombin activity and has been shown to attenuate local harmful effects of ischemia-reperfusion injury in many organs. In recent animal studies, delaying effect of remote organ ischemia-reperfusion injury on healing of intestinal anastomoses has been demonstrated. In this study, we investigated whether antithrombin III reduces deleterious systemic effects of ischemia-reperfusion injury on healing of colonic anastomoses in rats.
  
  
  METHODS
  Anastomosis of the left colon was performed in 24 rats that were divided into three groups: sham operated control (group I, n = 8), 30 minutes of intestinal ischemia-reperfusion by superior mesenteric artery occlusion (group II, n = 8), antithrombin III treated group (250 U/kg before and after the ischemia-reperfusion, group III, n = 8). On postoperative day 6, all animals were sacrificed, and bursting pressure and tissue hydroxyproline content of the anastomoses were assessed and compared.
  
  
  RESULTS
  On postoperative day 6 the mean bursting pressures were 149.6 +/- 4.8, 69.8 +/- 13.5, and 121.8 +/- 8.7 mm Hg for groups I, II, and III, respectively (P = 0.000). Mean tissue hydroxyproline concentration values were 389.5 +/- 29.6, 263.1 +/- 10.0, and 376.0 +/- 33.8 microg/mg for groups I, II, III respectively (P = 0.005).
  
  
  CONCLUSIONS
  This study showed that, antithrombin III treatment significantly prevented the delaying effect of remote organ ischemia-reperfusion injury on anastomotic healing in the colon. Further clinical studies are needed to clarify whether antithrombin may be a useful therapeutic agent to increase the safety of the anastomosis during particular operations where remote organ ischemia-reperfusion injury takes place.
authors.affiliation: Department of General Surgery, Pamukkale University Medical School, PK-32, 20003, Denizli, Turkey. koraytekin@yahoo.com
authors.forename: Koray
authors.initials: K
authors.lastname: Tekin
authors.forename: Faruk
authors.initials: F
authors.lastname: Aytekin
authors.forename: Akin
authors.initials: A
authors.lastname: Ozden
authors.forename: Ayşe
authors.initials: A
authors.lastname: Bilgihan
authors.forename: Ergün
authors.initials: E
authors.lastname: Erdem
authors.forename: Ugur
authors.initials: U
authors.lastname: Sungurtekin
authors.forename: Yildiz
authors.initials: Y
authors.lastname: Güney
mesh_terms: D000704:Analysis of Variance; D000714:Anastomosis, Surgical / Q000009:adverse effects* / Q000379:methods; D000818:Animals; D000990:Antithrombin III / Q000378:metabolism / Q000494:pharmacology*; D003082:Colectomy / Q000009:adverse effects* / Q000379:methods; D003108:Colonic Diseases / Q000601:surgery*; D004195:Disease Models, Animal; D005500:Follow-Up Studies; D008297:Male; D011336:Probability; D051381:Rats; D017208:Rats, Wistar; D012016:Reference Values; D015427:Reperfusion Injury / Q000503:physiopathology / Q000517:prevention & control*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D000990:Antithrombin III