The effects of the immunomodulators on the colonic anastomosis in an experimental model of intraperitoneal sepsis.
OBJECTIVE
The present study examined the effects of G-CSF and Levamisole used as immunomodulators on the colonic anastomosis healing in the presence of an intraabdominal infection.


METHODS
40 male Spraque-Dawley rats were randomly allocated to 4 groups each consisting of 10 animals. Standard colonic anastomosis, peritonitis and colonic anastomosis, peritonitis and colonic anastomosis and G-CSF, peritonitis and colonic anastomosis and Levamisole were applied to groups I, II, III and IV, respectively. The cecum of the rats in groups II, III and IV was ligated and perforated to create an intraabdominal sepsis model. G-CSF 50 microg/kg/day were given subcutaneously to group III and Levamisole 5 mg/kg/day were given perorally to group IV in the postoperative period until sacrifice. The rats were sacrificed on the fourth postoperative day. Bursting pressure and hydroxyproline level measurements of the anastomosis were evaluated.


RESULTS
Bursting pressures of all groups were lower than the control group (p<0.001). The mean bursting pressure of group III was significantly higher than group II (p<0.05). The mean level of hydroxyproline in group III was significantly higher than group II (p<0.05) however; overall, it was lower in all groups than the control (p<0.05).


CONCLUSIONS
This study demonstrated that intraabdominal sepsis adversely affects healing of colonic anastomosis, and healing of the anastomosis becomes better and the mortality rate decreases by the use of G-CSF.
Ergin
Erdal
E
Department of General Surgery, Cerrahpasa Medical School of Istanbul University, Istanbul, Turkey.
Paksoy
Melih
M
Erguney
Sabri
S
Uzun
Hafize
H
Sakoglu
Nevin
N
D000276:Adjuvants, Immunologic / Q000494:pharmacology* / Q000627:therapeutic use; D000714:Anastomosis, Surgical; D000818:Animals; D002432:Cecum / Q000601:surgery; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology* / Q000627:therapeutic use; D006909:Hydroxyproline / Q000032:analysis; D007978:Levamisole / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D018805:Sepsis / Q000188:drug therapy* / Q000503:physiopathology; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000503:physiopathology; D014945:Wound Healing / Q000187:drug effects*
D000276:Adjuvants, Immunologic; D016179:Granulocyte Colony-Stimulating Factor; D007978:Levamisole; D006909:Hydroxyproline