title: Diclofenac causes anastomotic leakage in the proximal colon but not in the distal colon of the rat.
abstract: BACKGROUND
  Nonsteroidal anti-inflammatory drugs have been associated with anastomotic leakage. It was studied if diclofenac affects anastomoses differently depending on the location in the gut.
  
  
  METHODS
  Ninety-five rats were randomized to 6 groups with an anastomosis in either ileum (IL), proximal colon (PC), or distal colon (DC). Groups IL+ (n = 10), PC+ (n = 30), and DC+ (n = 10) received diclofenac (3 mg/kg/day) from day 0 until sacrifice on day 3. Group PC- (n = 15) did not receive diclofenac. Groups PC1+ and PC2+ (n = 15 each) were given diclofenac from day 1 to 4 and from day 2 to 5.
  
  
  RESULTS
  Leak rates were 10/10 in group IL+, 22/30 in PC+, 1/10 in DC+, and 1/15 in PC-. Delayed administration of diclofenac by 1 or 2 days (6/15, P = .05) resulted in reduced leakage rates. Mechanical strength results corresponded with leak rates.
  
  
  CONCLUSIONS
  Diclofenac causes leakage of anastomoses in rat IL and PC, but not in the DC. This suggests a role for the ileal and proximal colonic content in diclofenac-induced leakage.
authors.affiliation: Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: simon.yauw@radboudumc.nl.
authors.forename: Simon T K
authors.initials: ST
authors.lastname: Yauw
authors.affiliation: Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Roger M L M
authors.initials: RM
authors.lastname: Lomme
authors.affiliation: Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Rozemarijn J
authors.initials: RJ
authors.lastname: van der Vijver
authors.affiliation: Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Thijs
authors.initials: T
authors.lastname: Hendriks
authors.affiliation: Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Kees J H M
authors.initials: KJ
authors.lastname: van Laarhoven
authors.affiliation: Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Harry
authors.initials: H
authors.lastname: van Goor
mesh_terms: D057868:Anastomotic Leak / Q000139:chemically induced*; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003106:Colon / Q000601:surgery*; D004008:Diclofenac / Q000009:adverse effects*; D008297:Male; D051381:Rats; D017208:Rats, Wistar
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac
keywords: Anastomotic leakage; Colon; Diclofenac; Ileum; NSAID