Mesenchymal Stem Cells and PRP Therapy Favorize Leak Closure After Sleeve Gastrectomy in Zucker Rats

Obes Surg. 2022 Apr;32(4):1251-1260. doi: 10.1007/s11695-022-05945-w. Epub 2022 Feb 22.

Abstract

Introduction: Sleeve gastrectomy (SG) is the most performed bariatric surgery but gastric leaks following SG occur in up to 2% of cases. Regenerative medicine is emerging as a promising field offering multiple possibilities in wound healing. We studied the efficiency of locally administered mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) on leak closure following SG in rats.

Methods: The amount of PRP and MSCs extracted from one rat was analyzed and a model of gastric leak was developed in 10-week-old male Zucker rats. Twenty-four rats underwent SG fashioned with a leak. After 24 h, a second surgery was performed. The control group was treated by peritoneal lavage and drainage only while the experimental group received an additional treatment of locally administered MSCs and PRP at the leak orifice. Analysis of the leak healing process was done by an anatomopathological examination of the stomach 1, 2, 3, and 4 weeks after SG.

Results: The extraction of MSCs and PRP from one rat was necessary for three recipients. Anatomopathological examination suggests that the closure of the leak orifice was faster in the experimental group. Statistical analysis revealed a significantly increased mucosae renewal and fibrosis score at the leak orifice after treatment with MSCs and PRP (p < 0.001).

Conclusion: These results suggest that PRP and MSCs may accelerate the closure of leaks following SG in rats and may become a new tool in the treatment of human gastric leaks but more research on this topic is needed to confirm these findings.

Keywords: Bariatric surgery; Gastric leak; Mesenchymal stem cell; Platelet-rich plasma; Regenerative medicine; Sleeve gastrectomy.

MeSH terms

  • Anastomotic Leak / surgery
  • Animals
  • Gastrectomy / adverse effects
  • Gastrectomy / methods
  • Humans
  • Male
  • Mesenchymal Stem Cells*
  • Obesity, Morbid* / surgery
  • Platelet-Rich Plasma*
  • Rats
  • Rats, Zucker