title: Liver cirrhosis on the colonic anastomotic healing in rats.
abstract: OBJECTIVE
  To investigate the effects of cirrhosis on colonic anastomosis healing in rats.
  
  
  METHODS
  Fifty five Wistar male rats were used (23 in the control group and 32 in the cirrhosis group). On the first day of the procedure, the rats in the cirrhosis group underwent double ligation and folding of the common bile duct to induce liver cirrhosis, and the control rats underwent a laparotomy and intestinal manipulation. On the fourteenth and thirty-fifth days, all of the animals were biochemically assessed for serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, bilirubin, total protein, and albumin and for liver histopathology. On the thirty-fifth day, cirrhosis was confirmed. On the twenty-eighth day, all of the animals were subjected to left colon transection and anastomosis. On the seventh day after the colonic anastomosis, the rats were sacrificed and macroscopically evaluated for dehiscence. The region of the colonic anastomosis was removed and subjected to hydroxyproline content measurement, conventional histology, and the immunohistochemical determination of vascular endothelial growth factor (VEGF) and matrix metalloproteinase type 1 (MMP 1).
  
  
  RESULTS
  The biochemical and histopathological examinations confirmed cirrhosis in all of the animals in the cirrhosis group. More deaths occurred after anastomosis in the cirrhosis group (5/25) than in the control group (0/21), and anastomotic dehiscence was more frequent in the cirrhosis group (8/25) than in the control group (0/21). The average hydroxyproline concentration was lower in the cirrhosis group than in the control group. The immunohistochemical studies showed that the average VEGF expression in the cirrhosis group was lower than in the control group, and the average MMP1 expression was higher in the cirrhosis group.
  
  
  CONCLUSIONS
  Hepatic cirrhosis leads to increased mortality and colonic anastomotic dehiscence, an increased distance between the mucosal edges of the anastomosis area, and a lower hydroxyproline concentration in the colonic anastomosis; therefore, these conditions are deleterious to healing.
authors: Department of Surgery and Anatomy, FMRP, USP, Ribeirao Preto, SP, Brazil.
authors: Marcelo
authors: M
authors: di Bonifácio
authors: Rogério Serafim
authors: RS
authors: Parra
authors: Ana Luiza Normanha Ribeiro de
authors: AL
authors: Almeida
authors: José Joaquim Ribeiro da
authors: JJ
authors: Rocha
authors: Omar
authors: O
authors: Feres
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D015415:Biomarkers / Q000032:analysis; D003106:Colon / Q000601:surgery*; D003135:Common Bile Duct / Q000473:pathology / Q000601:surgery; D006909:Hydroxyproline / Q000032:analysis; D008026:Ligation; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis; D008297:Male; D020781:Matrix Metalloproteinase 1 / Q000032:analysis*; D051381:Rats; D017208:Rats, Wistar; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis*; D014945:Wound Healing / Q000502:physiology*
chemical_list: D015415:Biomarkers; D042461:Vascular Endothelial Growth Factor A; D020781:Matrix Metalloproteinase 1; D006909:Hydroxyproline