The effect of remote ischemic preconditioning on healing of colonic anastomoses

J Surg Res. 2007 Dec;143(2):200-5. doi: 10.1016/j.jss.2006.10.030. Epub 2007 Sep 7.

Abstract

Background: We aimed to investigate the potential protective effect of remote ischemic preconditioning (IPC) on delayed colonic anastomotic healing induced by remote ischemia and reperfusion (I/R) injury.

Materials and methods: Forty male Wistar rats were randomly assigned into four groups, each consisting of 10 rats: the control group (C), the remote I/R group [I/R, 40 min of superior mesenteric artery (SMA) occlusion], the preconditioned I/R group (IPC, two cycles of 5 min temporary occlusion of SMA before an ischemic insult of 40 min), and the preconditioned group (PC, two cycles of 5 min temporary occlusion of SMA). Colonic anastomosis was performed immediately after the ischemic insult. Anastomotic healing was assessed on postoperative day 7 by determining anastomotic bursting pressure (ABP), tissue hydroxyproline content, histopathological examination, malondialdehyde (MDA), and nitric oxide levels.

Results: Remote I/R injury resulted with significant impairment in anastomotic healing in terms of mean ABP (P = 0.004), hydroxyproline content (P = 0.002), histopathological healing score (P = 0.001), nitric oxide level (P = 0.010), and MDA levels (P = 0.0001) when compared with the control group, but remote IPC did not improve all above mentioned parameters (P = NS for all), except MDA level (P = 0.011) when compared with I/R group. PC alone impaired the ABP (P = 0.0001), but it did not significantly change the other parameters measured (P = NS).

Conclusions: The results of this study showed that remote IPC did not prevent I/R-induced delaying in colonic anastomotic healing.

MeSH terms

  • Anastomosis, Surgical*
  • Animals
  • Arterial Occlusive Diseases / complications
  • Colon / blood supply
  • Colon / metabolism
  • Colon / surgery*
  • Hydroxyproline / metabolism
  • Ischemia / metabolism
  • Ischemia / pathology
  • Ischemia / therapy*
  • Ischemic Preconditioning / methods*
  • Male
  • Malondialdehyde / metabolism
  • Mesenteric Artery, Superior
  • Nitric Oxide / metabolism
  • Postoperative Complications / prevention & control
  • Pressure
  • Rats
  • Rats, Wistar
  • Wound Healing*

Substances

  • Nitric Oxide
  • Malondialdehyde
  • Hydroxyproline