Improvement of colonic healing by preoperative rectal irrigation with short-chain fatty acids in rats given radiotherapy.
BACKGROUND
We investigated the effect of preoperative rectal irrigation with short-chain fatty acids on irradiated colonic anastomosis in rats.


METHODS
Sixty male Wistar rats were divided into four groups. Group I (control group, n = 15) underwent left colon resection and primary anastomosis. Group II (Short-chain fatty acids pretreatment group, n = 15) had short-chain fatty acids rectal irrigation for five days preoperatively. Group III (preoperative radiotherapy group, n = 15) underwent irradiation to the whole pelvis eight and four days before the operation, for a total dose of 20 Gy. Group IV (preoperative radiotherapy group + short-chain fatty acids pretreatment group, n = 15) had rectal irrigation with short-chain fatty acids for five days after the second irradiation. Within each group, animals were anesthetized to assess the clinical, mechanical, histologic, and biochemical parameters of anastomotic healing on either the third or seventh postoperative days.


RESULTS
The mean bursting pressure was significantly low in Group III on Day 3 and was significantly high in Group IV on Day 7 (P = 0.001, P = 0.021). The burst occurred at the anastomoses in all animals tested on the third postoperative day, and outside of the anastomoses in all animals tested on the seventh postoperative day. The histologic parameters of anastomotic healing, such as epithelial regeneration and formation of granulation tissue, were significantly improved by use of preoperative rectal irrigation with short-chain fatty acids on Day 7. The amount of total and salt-soluble collagen concentrations significantly increased in Group IV compared with the control group on Day 3 (P = 0.008, P = 0.004).


CONCLUSIONS
Some mechanical and histologic aspects of colonic anastomotic healing can be adversely affected by preoperative radiotherapy, but rectal irrigation with short-chain fatty acids may improve anastomotic healing.
Terzi
Cem
C
Department of Surgery, Medical Faculty of Dokuz Eylül University, Izmir, Turkey. cem.terzi@deu.edu.tr
Sevinç
Ali Ibrahim
AI
Koçdor
Hilal
H
Oktay
Gülgün
G
Alanyali
Hilmi
H
Küpelioğlu
Ali
A
Ergör
Gül
G
Füzün
Mehmet
M
D000714:Anastomosis, Surgical / Q000009:adverse effects; D000818:Animals; D003082:Colectomy / Q000009:adverse effects; D003094:Collagen / Q000032:analysis / Q000737:chemistry / Q000187:drug effects / Q000528:radiation effects; D003110:Colonic Neoplasms / Q000628:therapy*; D004195:Disease Models, Animal; D004353:Drug Evaluation, Preclinical; D004733:Enema / Q000379:methods; D005232:Fatty Acids, Volatile / Q000008:administration & dosage* / Q000494:pharmacology; D006097:Granulation Tissue / Q000737:chemistry / Q000187:drug effects / Q000528:radiation effects; D008297:Male; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D011300:Preoperative Care / Q000379:methods*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*; D051381:Rats; D017208:Rats, Wistar; D012007:Rectum; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D013718:Tensile Strength; D007507:Therapeutic Irrigation / Q000379:methods*; D013997:Time Factors; D015431:Weight Loss; D014945:Wound Healing / Q000187:drug effects / Q000528:radiation effects
D005232:Fatty Acids, Volatile; D003094:Collagen