title: [Early enteral and glutamine enriched enteral feeding ameliorates healing of colonic anastomosis: experimental study].
abstract: BACKGROUND
  To investigate the effects of postoperative early enteral and glutamine enriched enteral feeding on the healing of experimental colonic anastomosis.
  
  
  METHODS
  Forty Wistar-albino rats were equally divided into 4 groups. Colonic transsection and anastomosis situated at the distal left colon was performed on all animals. Animals in groups 1 and 2 received late total enteral nutrition (TEN) and in groups 3 and 4 early TEN. Glutamine was added to TEN protocol in groups 2 and 4. The colonic segment including the anastomosis was excised at the end of the 7th day postoperatively. Bursting pressure of the anastomosis and tissue hydroxyproline levels were determined.
  
  
  RESULTS
  Bursting pressure levels were 111.6 and 95.8 centimeters of water (cmH(2)O) in early and late nutrition groups, respectively (p=0.022). Comparison of late TEN groups showed a significant difference in favor of group with glutamine (95.8 vs 138.5 cmH(2)O; p<0.0001). Highest bursting pressures (139 and 138.5 cmH(2)O) were measured in both early and late TEN groups with glutamine. Tissue hydroxyproline level in early TEN group (2440.3 microg) was significantly higher than late TEN group (1509.6 microg; p=0.024). Comparison of late TEN groups showed a considerable but not statistically significant difference (p=0.276) in favor of group with glutamine (1509.6 vs 1981.6 microg).
  
  
  CONCLUSIONS
  Postoperative early TEN significantly ameliorates the resistance of the anastomosis and collagen synthesis. Glutamine enrichment in nutritional protocol decreases and reverses the disadvantages of late TEN regarding the resistance of anastomosis. A similarly positive, albeit weaker, effect of glutamine supplementation is also seen on collagen synthesis.
authors.affiliation: Department of General Surgery, Medicine Faculty of Abant Izzet Baysal University, Düzce, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Gökpinar
authors.forename: Emin
authors.initials: E
authors.lastname: Gürleyik
authors.forename: Mevlut
authors.initials: M
authors.lastname: Pehlivan
authors.forename: Omer
authors.initials: O
authors.lastname: Ozcan
authors.forename: Ismet
authors.initials: I
authors.lastname: Ozaydin
authors.forename: Arif
authors.initials: A
authors.lastname: Aslaner
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Demiraran
authors.forename: Mustafa
authors.initials: M
authors.lastname: Gültepe
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D003108:Colonic Diseases / Q000601:surgery*; D004750:Enteral Nutrition; D005973:Glutamine / Q000008:administration & dosage*; D008297:Male; D011182:Postoperative Care; D051381:Rats; D017208:Rats, Wistar; D014945:Wound Healing
chemical_list: D005973:Glutamine