title: The effect of remote ischemic preconditioning on healing of colonic anastomoses.
abstract: 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.
authors.affiliation: Department of General Surgery, Mersin University, Faculty of Medicine, Mersin, Turkey. tcolak@mersin.edu.tr
authors.forename: Tahsin
authors.initials: T
authors.lastname: Colak
authors.forename: Ozgur
authors.initials: O
authors.lastname: Turkmenoglu
authors.forename: Ahmet
authors.initials: A
authors.lastname: Dag
authors.forename: Ayse
authors.initials: A
authors.lastname: Polat
authors.forename: Ulku
authors.initials: U
authors.lastname: Comelekoglu
authors.forename: Ozlen
authors.initials: O
authors.lastname: Bagdatoglu
authors.forename: Gurbuz
authors.initials: G
authors.lastname: Polat
authors.forename: Arzu
authors.initials: A
authors.lastname: Kanik
authors.forename: Tamer
authors.initials: T
authors.lastname: Akca
authors.forename: Suha
authors.initials: S
authors.lastname: Aydin
mesh_terms: 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