Evaluating the safety of two human experimental intestinal ischemia reperfusion models: A retrospective observational study

PLoS One. 2021 Jun 18;16(6):e0253506. doi: 10.1371/journal.pone.0253506. eCollection 2021.

Abstract

Background: We developed a jejunal and colonic experimental human ischemia-reperfusion (IR) model to study pathophysiological intestinal IR mechanisms and potential new intestinal ischemia biomarkers. Our objective was to evaluate the safety of these IR models by comparing patients undergoing surgery with and without in vivo intestinal IR.

Methods: A retrospective study was performed comparing complication rates and severity, based on the Clavien-Dindo classification system, in patients undergoing pancreatoduodenectomy with (n = 10) and without (n = 20 matched controls) jejunal IR or colorectal surgery with (n = 10) and without (n = 20 matched controls) colon IR. Secondary outcome parameters were operative time, blood loss, 90-day mortality and length of hospital stay.

Results: Following pancreatic surgery, 63% of the patients experienced one or more postoperative complications. There was no significant difference in incidence or severity of complications between patients undergoing pancreatic surgery with (70%) or without (60%, P = 0.7) jejunal IR. Following colorectal surgery, 60% of the patients experienced one or more postoperative complication. Complication rate and severity were similar in patients with (50%) and without (65%, P = 0.46) colonic IR. Operative time, amount of blood loss, postoperative C-reactive protein, length of hospital stay or mortality were equal in both intervention and control groups for jejunal and colon IR.

Conclusion: This study showed that human experimental intestinal IR models are safe in patients undergoing pancreatic or colorectal surgery.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Animals
  • Colorectal Surgery / adverse effects*
  • Female
  • Humans
  • Intestines / blood supply*
  • Ischemia / etiology
  • Ischemia / pathology*
  • Length of Stay
  • Male
  • Middle Aged
  • Pancreaticoduodenectomy / adverse effects*
  • Postoperative Complications / etiology
  • Postoperative Complications / pathology
  • Postoperative Period
  • Reperfusion Injury / etiology
  • Reperfusion Injury / pathology*
  • Retrospective Studies

Grants and funding

Supported by the Dutch Digestive Foundation: MLDS Career development grant CDG13-14 to J.P.M. Derikx. https://www.mlds.nl/ The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.