Effects of preoperative pelvic irradiation on colonic anastomosis healing: an experimental study in rats

Acta Cirurgica Brasileira

Alexandre Franca²  Fernando Silva Ramalho¹  Leandra Naira Zambelli Ramalho¹  José Joaquim Ribeiro Da Rocha²  Omar Féres² 

[1] ,University of São Paulo Ribeirão Preto Faculty of Medicine Department of Surgery and Anatomy,Brazil

关键词: Colorectal Anastomosis;    Preoperative Irradiation;    Healing;    Dehiscences;    Irradiation;    Colorectal Cancer;    Anastomose Colorretal;    Cicatrização;    Deiscências;    Radioterapia;    Câncer Colorretal;   

DOI  :  10.1590/S0102-86502008000700005

来源: SciELO

【 摘 要 】

PURPOSE: Colorectal anastomosis is a constant worry-issue among surgeons because of high rates of complications, specially the dehiscence. The preoperative irradiation on cancer surgeries might interfere in the healing process, leading to an unfavorable outcome. METHODS: In the present study, two groups of rats were irradiated previously to a colorectal anastomosis surgery, with intervals of 4 and 8 weeks between the procedures. Seven days after the surgery, healing process was evaluated for dehiscence presence and histologic inflammatory characteristics. Also, levels of hydroxyproline, metalloproteinases and vascular endothelial growth factor were measured. RESULTS: Our results showed a higher incidence of dehiscences on the animals submitted to irradiation, compared to controls, with a reduced inflammatory activity in the healing tissue. DISCUSSION: Comparing both irradiated groups, those irradiated 8 weeks before surgery showed higher levels of hydroxyproline and metalloproteinases, indicating higher efficiency of the healing process. In conclusion, preoperative irradiation interferes with intestinal anastomosis healing and a larger time interval between both procedures is safer in terms of the healing quality.

【 授权许可】

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