title: The effects of hyperthermic intraperitoneal chemoperfusion on colonic anastomosis: an experimental study in a rat model.
abstract: BACKGROUND
  Cytoreductive surgery (CRS) with subsequent hyperthermic intraperitoneal chemotherapy (HIPEC) is a promising modality to treat and prevent peritoneal metastases. However, this treatment is associated with signficant morbidity and mortality. Whether or not CRS with HIPEC interferes with anastomotic healing has also been debated. This study was designed to investigate the effects of mitomycin C, cisplatin, oxaliplatin, and doxorubicin used in HIPEC treatment on colonic anastomosis healing in a rat model.
  
  
  METHODS
  Sixty Wistar albino rats were employed in the study. Sigmoid resection and end-to-end colorectal anastomosis was performed in all rats. Group 1 rats underwent the surgical procedure alone, while group 2 rats were given hyperthermic intraperitoneal lavage with heated saline following surgery. Groups 3, 4, 5, and 6 had surgery with concomitant HIPEC treatment with mitomycin C, cisplatin, oxaliplatin, and doxorubicin, respectively. Anastomotic bursting pressures and hydroxyproline levels were evaluated.
  
  
  RESULTS
  Regarding the hydroxyproline levels, groups 1 and 2 showed significantly higher values than other groups (p<0.001). However, there was no significant difference between the HIPEC treatment groups (groups 3, 4, 5, and 6) (p>0.05). When groups were compared regarding bursting pressure values, no significant differences were observed (p = 0.81).
  
  
  CONCLUSIONS
  This study demonstrated that the HIPEC procedure with mitomycin C, cisplatin, oxaliplatin and doxorubicin had negative effects on hydroxyproline levels, but had no detrimental effect on anastomotic bursting pressure in a rat model.
authors.affiliation: Department of General Surgery, Acibadem University, School of Medicine, Istanbul - Turkey.
authors.forename: Afag
authors.initials: A
authors.lastname: Aghayeva
authors.affiliation: Istanbul University, Cerrahpasa Medical School, Istanbul - Turkey.
authors.forename: Cigdem
authors.initials: C
authors.lastname: Benlice
authors.affiliation: Istanbul University, Cerrahpasa Medical School, Istanbul - Turkey.
authors.forename: Ismail Ahmet
authors.initials: IA
authors.lastname: Bilgin
authors.affiliation: Department of Biochemistry, Istanbul University, Cerrahpasa School of Medicine, Istanbul - Turkey.
authors.forename: Pinar
authors.initials: P
authors.lastname: Atukeren
authors.affiliation: Department of Pathology, Gayrettepe Florence Nightingale Hospital, Istanbul - Turkey.
authors.forename: Gulen
authors.initials: G
authors.lastname: Dogusoy
authors.affiliation: Department of Public Health, Acibadem University, School of Medicine, Istanbul - Turkey.
authors.forename: Figen
authors.initials: F
authors.lastname: Demir
authors.affiliation: Department of General Surgery, Acibadem University, School of Medicine, Istanbul - Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Atasoy
authors.affiliation: Department of General Surgery, Acibadem University, School of Medicine, Istanbul - Turkey.
authors.forename: Bilgi
authors.initials: B
authors.lastname: Baca
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures; D004195:Disease Models, Animal; D004317:Doxorubicin / Q000008:administration & dosage; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D010537:Peritoneum / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D051381:Rats
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D016685:Mitomycin; D004317:Doxorubicin; D002945:Cisplatin