Antithrombin III prevents deleterious effects of remote ischemia-reperfusion injury on healing of colonic anastomoses.
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.
Tekin
Koray
K
Department of General Surgery, Pamukkale University Medical School, PK-32, 20003, Denizli, Turkey. koraytekin@yahoo.com
Aytekin
Faruk
F
Ozden
Akin
A
Bilgihan
Ayşe
A
Erdem
Ergün
E
Sungurtekin
Ugur
U
Güney
Yildiz
Y
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
D000990:Antithrombin III