title: Effects of a Glutamine Enema on Anastomotic Healing in an Animal Colon Anastomosis Model.
abstract: OBJECTIVE
  Anastomotic leakage in colorectal surgery is a very important issue. Although many studies have shown the positive effects of enteral glutamine (Gln) on anastomotic healing, none has assessed the effects of administering Gln via an enema for anastomotic healing. To fill this study gap, this study investigated the intraluminal effect of administration of Gln enema on the healing of colonic anastomosis in a rat model.
  
  
  METHODS
  Thirty Wistar albino rats were divided into three groups containing 10 rats each and were subjected to distal left colon transection and anastomosis. Postoperatively, group I (the control group) was administered no treatment, group II was administered daily placebo enemas containing physiological saline, and group III was administered daily 2% L-Gln enemas. After sacrifice on postoperative day 5, anastomotic healing, burst pressure, tissue hydroxyproline levels, and histological parameters were measured, and group values were compared via statistical analysis.
  
  
  RESULTS
  Group III was found to have the highest mean bursting pressure and tissue hydroxyproline levels and the lowest mean ischemia score. While the values of these parameters were not found to differ significantly among the groups, the lack of significance may have been due to the limited number of subjects examined.
  
  
  CONCLUSIONS
  Administration of a Gln enema may have a positive effect on anastomosis in terms of bursting pressure and histopathological parameters. Future research should examine administration of a preoperative Gln enema as a means of decreasing the traumatic effects of the enema and identifying its applicability in surgical practice.
authors.affiliation: Department of General Surgery, Esenler Maternity and Child Health Hospital, Istanbul, Turkey.
authors.forename: Mani
authors.initials: M
authors.lastname: Habibi
authors.affiliation: Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey.
authors.forename: Osman Zekai
authors.initials: OZ
authors.lastname: Oner
authors.affiliation: Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey.
authors.forename: Mehmet Tahir
authors.initials: MT
authors.lastname: Oruc
authors.affiliation: Department of General Surgery, Akdeniz University, School of Medicine, Antalya, Turkey.
authors.forename: Nurullah
authors.initials: N
authors.lastname: Bulbuller
authors.affiliation: Department of Biochemistry, Akdeniz University, School of Medicine, Antalya, Turkey.
authors.forename: Sebahat
authors.initials: S
authors.lastname: Ozdem
authors.affiliation: Department of General Surgery, Karapınar State Hospital, Konya, Turkey.
authors.forename: Sukru
authors.initials: S
authors.lastname: Ozdemir
authors.affiliation: Department of Pathology, Antalya Training and Research Hospital, Antalya, Turkey.
authors.forename: Arsenal Sezgin
authors.initials: AS
authors.lastname: Alikanooglu
authors.affiliation: Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey.
authors.forename: Rojbin
authors.initials: R
authors.lastname: Karakoyun
authors.affiliation: Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey.
authors.forename: Ugur
authors.initials: U
authors.lastname: Dogan
authors.affiliation: Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey.
authors.forename: Ayper
authors.initials: A
authors.lastname: Ongen
authors.affiliation: Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey.
authors.forename: Umit
authors.initials: U
authors.lastname: Koc
keywords: Anastomotic Leak; Enema; Glutamine; Hydroxyproline; Surgical anastomosis
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