Effect of corticosteroid dose and duration of administration on colonic anastomosis.
BACKGROUND
Surgical intervention under concomitant steroid therapy can be complicated by impaired anastomotic healing. The aim of this experimental study was to investigate the effects of a corticosteroid (methylprednisolone) on healing colonic anastomoses in relation to the dose and duration of administration.


METHODS
Fifty male Spraque-Dawley rats weighing 200-220 g were divided into five groups each containing 10 rats. No treatment was given in the control group. Group HDST: high-dose methylprednisolone (1 mg/kg/day, intramuscular) treatment for a short term of 2 days; group HDLT: high-dose methylprednisolone treatment for a long term of 60 days; group LDST: low-dose methylprednisolone (0.28 mg/kg/day) treatment for a short term of 2 days; and group LDLT: low-dose methylprednisolone treatment for a long term of 60 days. Standard left colonic anastomosis was performed in all rats. Anastomotic bursting pressure, hydroxyproline measurement, and histopathological data were evaluated in all groups on postoperative day 4.


RESULTS
The mean anastomotic bursting pressure value was significantly lower in the HDLT group (P < 0.05). The mean hydroxyproline levels were significantly lower in all groups (P < 0.05). Histopathological results demonstrated significant changes according to neutrophil infiltration, granulation tissue formation, presence of vascularization, and peritonitis in the HDLT, LDST, and LDLT groups (P < 0.05).


CONCLUSIONS
High and low doses of the corticosteroid produced adverse effects on the healing of colon anastomosis in rats regardless of whether it was administered over a long or short preoperative period. However, the most prominent negative effect was associated with high-dose, long-term corticosteroid administration.
Baca
Bilgi
B
Department of General Surgery, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey. bilgib@istanbul.edu.tr
Ozben
Volkan
V
Boler
Deniz Eren
DE
Onur
Ender
E
Hamzaoglu
Ismail
I
Karahasanoglu
Tayfun
T
Erdamar
Sibel
S
Atukeren
Pinar
P
Dirican
Ahmet
A
D000714:Anastomosis, Surgical; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D003106:Colon / Q000601:surgery*; D006909:Hydroxyproline / Q000378:metabolism; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D051381:Rats; D017207:Rats, Sprague-Dawley; D014945:Wound Healing / Q000187:drug effects*
D000893:Anti-Inflammatory Agents; D006909:Hydroxyproline; D008775:Methylprednisolone