title: Does sildenafil reverse the adverse effects of ischemia on ischemic colon anastomosis: yes, 'no'.
abstract: 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.
authors.affiliation: Department of General Surgery, Zonguldak Karaelmas University, School of Medicine, Kozlu, Zonguldak, Turkiye. oktaytip@yahoo.com
authors.forename: Oktay
authors.initials: O
authors.lastname: Irkorucu
authors.forename: Bulent Hamdi
authors.initials: BH
authors.lastname: Ucan
authors.forename: Guldeniz Karadeniz
authors.initials: GK
authors.lastname: Cakmak
authors.forename: Ali Ugur
authors.initials: AU
authors.lastname: Emre
authors.forename: Oge
authors.initials: O
authors.lastname: Tascilar
authors.forename: Ebru
authors.initials: E
authors.lastname: Ofluoglu
authors.forename: Burak
authors.initials: B
authors.lastname: Bahadir
authors.forename: Kemal
authors.initials: K
authors.lastname: Karakaya
authors.forename: Canan
authors.initials: C
authors.lastname: Demirtas
authors.forename: Handan
authors.initials: H
authors.lastname: Ankarali
authors.forename: Gurkan
authors.initials: G
authors.lastname: Kertis
authors.forename: Hatice
authors.initials: H
authors.lastname: Pasaoglu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Comert
mesh_terms: 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
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate