The effect of remote ischemic preconditioning on healing of colonic anastomoses.
BACKGROUND
We aimed to investigate the potential protective effect of remote ischemic preconditioning (IPC) on delayed colonic anastomotic healing induced by remote ischemia and reperfusion (I/R) injury.


METHODS
Forty male Wistar rats were randomly assigned into four groups, each consisting of 10 rats: the control group (C), the remote I/R group [I/R, 40 min of superior mesenteric artery (SMA) occlusion], the preconditioned I/R group (IPC, two cycles of 5 min temporary occlusion of SMA before an ischemic insult of 40 min), and the preconditioned group (PC, two cycles of 5 min temporary occlusion of SMA). Colonic anastomosis was performed immediately after the ischemic insult. Anastomotic healing was assessed on postoperative day 7 by determining anastomotic bursting pressure (ABP), tissue hydroxyproline content, histopathological examination, malondialdehyde (MDA), and nitric oxide levels.


RESULTS
Remote I/R injury resulted with significant impairment in anastomotic healing in terms of mean ABP (P = 0.004), hydroxyproline content (P = 0.002), histopathological healing score (P = 0.001), nitric oxide level (P = 0.010), and MDA levels (P = 0.0001) when compared with the control group, but remote IPC did not improve all above mentioned parameters (P = NS for all), except MDA level (P = 0.011) when compared with I/R group. PC alone impaired the ABP (P = 0.0001), but it did not significantly change the other parameters measured (P = NS).


CONCLUSIONS
The results of this study showed that remote IPC did not prevent I/R-induced delaying in colonic anastomotic healing.
Colak
Tahsin
T
Department of General Surgery, Mersin University, Faculty of Medicine, Mersin, Turkey. tcolak@mersin.edu.tr
Turkmenoglu
Ozgur
O
Dag
Ahmet
A
Polat
Ayse
A
Comelekoglu
Ulku
U
Bagdatoglu
Ozlen
O
Polat
Gurbuz
G
Kanik
Arzu
A
Akca
Tamer
T
Aydin
Suha
S
D000714:Anastomosis, Surgical; D000818:Animals; D001157:Arterial Occlusive Diseases / Q000150:complications; D003106:Colon / Q000098:blood supply / Q000378:metabolism / Q000601:surgery*; D006909:Hydroxyproline / Q000378:metabolism; D007511:Ischemia / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D019194:Ischemic Preconditioning / Q000379:methods*; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D017538:Mesenteric Artery, Superior; D009569:Nitric Oxide / Q000378:metabolism; D011183:Postoperative Complications / Q000517:prevention & control; D011312:Pressure; D051381:Rats; D017208:Rats, Wistar; D014945:Wound Healing