title: Effects of intraperitoneal bevacizumab administration on colonic anastomosis and early postoperative adhesion formation.
abstract: OBJECTIVE
  The purpose of this study is to investigate the effect of intraperitoneal (IP) bevacizumab on colonic anastomosis and evaluate the effects on early postoperative adhesion formation.
  
  
  METHODS
  A total of 24 mature female Sprague-Dawley rats were used for this study. Rats were randomly assigned to a control group that received saline (n = 8) or to experimental groups (n = 8 each) that received bevacizumab at a dose of 2.5 mg/kg (group 1) or 5 mg/kg (group 2). Animals were killed humanely on the seventh day after operation, and measurements of anastomotic strength and biochemical variables were performed.
  
  
  RESULTS
  The mean adhesion grade was 2.63 ± 0.92, and 1 ± 0.93 and 0.75 ± 0.71 for the control and test groups, respectively. Bevacizumab significantly reduced adhesion formation in both low-dose and high-dose IP applications (P < .05). When all groups were compared, it was found that VEGF levels decreased significantly only in the tissue (P = .001), whereas there was no significant difference in the blood and the IP fluid (P = .73 and .08, respectively). We evaluated hydroxyproline levels, anastomosis bursting pressure, and histopathological healing scores. When each of these parameters were examined, there was statistical difference between groups (P = .01, .004, and .01, respectively). It was found that these parameters significantly decreased depending on increasing drug dose.
  
  
  CONCLUSIONS
  IP administration of bevacizumab effectively reduced the formation of adhesions and caused significant impairment of anastomotic wound healing when standard doses were administered (5 mg/kg), but the 2.5-mg/kg dosage did not affect the anastomotic wound healing and also effectively reduced the formation of adhesions.
authors.affiliation: 1Istanbul University Institute of Oncology, Istanbul, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Karanlik
authors.forename: Atilla
authors.initials: A
authors.lastname: Kurt
authors.forename: Enver
authors.initials: E
authors.lastname: Kunduz
authors.forename: Kursat
authors.initials: K
authors.lastname: Serin
authors.forename: Sezer
authors.initials: S
authors.lastname: Saglam
authors.forename: Hilal Oguz
authors.initials: HO
authors.lastname: Soydinc
authors.forename: Vildan
authors.initials: V
authors.lastname: Yasasever
authors.forename: Vakur
authors.initials: V
authors.lastname: Olgac
authors.forename: Oktar
authors.initials: O
authors.lastname: Asoglu
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods*; D000818:Animals; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D001696:Biomechanical Phenomena / Q000187:drug effects; D005260:Female; D007274:Injections, Intraperitoneal; D011183:Postoperative Complications / Q000188:drug therapy / Q000517:prevention & control; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D000267:Tissue Adhesions / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; C467498:vascular endothelial growth factor A, rat; D000068258:Bevacizumab
keywords: anastomoses healing; bevacizumab; intraperitoneal chemotherapy