Does sildenafil reverse the adverse effects of ischemia on ischemic colon anastomosis: yes, 'no'.
BACKGROUND
Sildenafil may lead an improvement in anastomotic healing of ischemic left colon anastomosis.


METHODS
Thirty-six male Wistar albino rats were randomized into four experimental groups (n=9 in each group). In group 1, a well-perfused left colonic segment was transected, and free ends were anatomosed. In groups 2, 3 and 4 animals underwent a standardized surgical procedure to induce ischemic left colon anastomosis. Group 2 animals received only tap water. In groups 3 and 4 animals received 10mg/kg/body-weight and 20mg/kg/body-weight sildenafil, single dose a day during 4 days, respectively. Rats were sacrificed on day 4 following operation. Anastomotic integrity, intra-peritoneal adhesion scores, anastomotic bursting pressures and tissue hydroxyproline levels were recorded. Histopathological examination of the anastomosis was also performed.


RESULTS
There was no statistically significant difference among groups with respect to anastomotic integrity (p=0.142) but ischemia decreased the anastomotic bursting pressure. The mean bursting pressure values were 78.8+/-24.1, 43.3+/-26, 55.1+/-32.4, and 43.3+/-20.4 in groups 1, 2, 3, and 4, respectively. Group 1 had the highest values whereas; there was no statistically significant difference between groups 1 and 3. There was no statistically significant difference among groups 2, 3, and 4 with respect to tissue hydroxyproline levels, adhesion scores and the Chiu scores. The highest inflammatory cell presence in the granulation tissue was detected in group 2, whereas the lowest was detected in group 4 (p=0.0001). The highest fibroblast infiltration in the granulation tissue was detected in group 1 (p=0.045).


CONCLUSIONS
Our results showed that 10mg/kg sildenafil decreased the adverse effects of ischemia on the healing of ischemic left colon anastomosis. Additional investigations are needed to confirm the effects of phosphodiesterase-5 inhibitors in ischemic colon anastomosis models.
Irkorucu
Oktay
O
Department of General Surgery, Zonguldak Karaelmas University, School of Medicine, Kozlu, Zonguldak, Turkiye. oktaytip@yahoo.com
Ucan
Bulent Hamdi
BH
Cakmak
Guldeniz Karadeniz
GK
Emre
Ali Ugur
AU
Tascilar
Oge
O
Ofluoglu
Ebru
E
Bahadir
Burak
B
Karakaya
Kemal
K
Demirtas
Canan
C
Ankarali
Handan
H
Kertis
Gurkan
G
Pasaoglu
Hatice
H
Comert
Mustafa
M
D000714:Anastomosis, Surgical / Q000009:adverse effects; D000818:Animals; D003106:Colon / Q000098:blood supply* / Q000601:surgery*; D007511:Ischemia / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology; D008297:Male; D010879:Piperazines / Q000627:therapeutic use*; D011687:Purines / Q000627:therapeutic use; D051381:Rats; D017208:Rats, Wistar; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use*; D013536:Suture Techniques; D000267:Tissue Adhesions / Q000209:etiology / Q000473:pathology; D014665:Vasodilator Agents / Q000627:therapeutic use*; D014945:Wound Healing
D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate