The effect of NG-nitro L-arginine methyl ester on colonic anastomosis after increased intra-abdominal pressure.
BACKGROUND
Intestinal ischemia-reperfusion (I/R) is associated with augmented nitric oxide (NO) production. Increased intra-abdominal pressure (IAP) during surgical pneumoperitoneum (P) facilitates I/R injury. We previously demonstrated decreased strength and healing of colocolic anastomoses after high IAPs. The effect of an NO synthase inhibitor, N (G)-nitro-arginine methyl ester (L: -NAME), on anastomoses realized in colonic tissue exposed to high IAPs was investigated in this study, a randomized, controlled, and experimental study with blind outcome assessment.


METHODS
Fifty Wistar-albino rats were randomized to five groups; all underwent colocolic anastomosis. P was maintained for 60 min at IAPs of 14, 20, 25, and 30 mmHg in study groups 1, 2, 3, and 4, respectively; P was preceded by intraperitoneal L: -NAME (2.5 mg/kg) and followed by anastomosis. The control group was not subjected to IAP or L: -NAME.


RESULTS
Anastomosis bursting pressure (ABP) values and histopathological findings were determined on the 7th-14th postoperative days. The ABPs of groups 3-4 were significantly lower than the others. Groups 1-2 had results similar to controls. Histopathological findings of the groups were consistent with their ABPs.


CONCLUSIONS
Administration of a 2.5-mg/kg intraperitoneal L: -NAME dose was found to provide a beneficial role, implying a role in impaired anastomotic healing after IAPs of 14 and 20 mmHg.
Polat
C
C
Department of Surgery, Afyon Kocatepe University, Afyonkarahisar, Turkey. coskunpolat2001@yahoo.com
Arikan
Y
Y
Gokce
C
C
Aktepe
F
F
Akbulut
G
G
Yilmaz
S
S
Gokce
O
O
D000714:Anastomosis, Surgical; D000818:Animals; D003106:Colon / Q000601:surgery*; D004791:Enzyme Inhibitors / Q000494:pharmacology*; D008297:Male; D019331:NG-Nitroarginine Methyl Ester / Q000494:pharmacology*; D019001:Nitric Oxide Synthase / Q000037:antagonists & inhibitors*; D018384:Oxidative Stress / Q000187:drug effects / Q000502:physiology; D011184:Postoperative Period; D011312:Pressure; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000150:complications / Q000517:prevention & control; D014945:Wound Healing / Q000187:drug effects*
D004791:Enzyme Inhibitors; D019001:Nitric Oxide Synthase; D019331:NG-Nitroarginine Methyl Ester