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Research Article
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Effect of the wrapping of experimentally induced ischemic colonic anastomoses with the amniotic membrane on anastomosis safety in rats.

Year 2018, Volume: 40 Issue: 3, 291 - 298, 30.09.2018

Sinan Soylu , Zeynep Deniz Şahin İnan

https://doi.org/10.7197/223.vi.460562

Abstract

Objective: Colonic
anastomotic leakage represents a complication with high mortality and
morbidity. In the present study, it was aimed to examine the effect of the amniotic
membrane on the healing of ischemic
colonic anastomosis.



Methods: 25
pregnant Wistar albino rats aged 19-21 days were randomly divided into 5
groups. With midline laparotomy, pregnancies were terminated, and fresh amniotic membranes were obtained. In Group
1 Sham (S), no procedure except for laparotomy was performed. In Group 2 of colonic
anastomosis (A), the descending colon was completely transected and
anastomosed. In Group 3 of amniotic anastomosis (AA), the anastomosis line was
fixed by being wrapped with the fresh amniotic membrane. In Group
4 of colonic ischemic anastomosis (IA), the marginal arteries were ligated
after descending colon transection.
Ischemia was induced, and anastomosis was performed. In Group 5 of colonic ischemic anastomosis wrapped with the amniotic
membrane (AIA), after ischemic colonic anastomosis was performed, the
anastomosis line was fixed by being wrapped with the amniotic membrane. On the
postoperative 7th day, rats were sacrificed, and
their anastomotic bursting pressures were measured. For histological examination,
the colon segment containing the anastomosis line was removed. Hematoxylin-eosin and Van Gieson trichrome
stained specimens were histologically evaluated and scored according to the Ehrlich-Hunt
model.



Results: Anastomotic
bursting pressures were measured in group S as the highest, in AA, AIA, A in a decreasing order and in group IA as the
lowest. The difference between groups S and AA was statistically insignificant
in the paired comparison of groups according to their bursting pressure values
(p=0.222). When the other pairs were compared, the difference between the
groups was calculated as significant (p< 0.05). According to the
Ehrlich-Hunt model, the total score was the highest in AIA group, decreased in
AA, IA, A groups in a decreasing order,
and was the lowest in group S. A paired comparison for total scores between the
groups was statistically insignificant between groups S and A (p=0.222). Other
paired comparisons were statistically significant (p< 0.05).



Conclusion: Wrapping
the colon anastomosis line with the amniotic membrane gave positive results
both in the ischemic colon as well as in the non-ischemic colon in terms of
bursting pressure and histological anastomosis safety.

Keywords

Ischemic colon Anastomosis safety amniotic membrane

References

  • 1.Uludag M, Citgez B, Ozkaya O, Yetkin G, Ozcan O, Polat N, et al. Effects of amniotic membrane on the healing of primary colonic anastomoses in the cecal ligation and puncture model of secondary peritonitis in rats. Int J Colorectal Dis. 2009; 24(5): 559-67[DOI][PubMed]
  • 2.Kruschewski M, Rieger H, Pohlen U, Hotz HG, Buhr HJ. Risk factors for clinical anastomotic leakage and postoperative mortality in elective surgery for rectal cancer. Int J Colorectal Dis. 2007; 22(8): 919-27[DOI][PubMed]
  • 3. Nursal TZ, Anarat R, Bircan S, et al. The effect of tissue adhesive, octyl-cyanoacrylate, on the healing of experimental high-risk and normal colonic anastomoses. Am J Surg.2004;187:28–32.
  • 4. NasirKhan MU, Abir F, Longo W, et al. Anastomotic disruption after bowel resection. World J Gastroenterol. 2006;12(16):2497–2504.
  • 5.Zhou B, Ren J, Ding C, et al. Protection of colonic anastomosis with platelet-rich plasma gel in the open abdomen. Injury. 2014;45:864-868.
  • 6.Wenger FA, Szucsik E, Hoinoiu BF, Cimpean AM, Ionac M, Raica M. Circular anastomotic experimental fibrin sealant protection in deep colorectal anastomosis in pigs in a randomized 9-day survival study. Int J Colorectal Dis. 2015;30:1029-1039.
  • 7. Cueto J, Barrientos T, Rodriguez E, et al. Further experimental studies on a biodegradable adhesive for protection of colorectal anastomosis. Arch Med Res. 2014;45: 331-336.
  • 8. Hoare T, Yeo Y, Bellas E, Bruggeman JP, Kohane DS. Prevention of peritoneal adhesions using polymeric rheological blends. Acta Biomater. 2014;10:1187-1193
  • 9. Kawanishi K, Yamato M, Sakiyama R, Okano T, Nitta K. Peritoneal cell sheets composed of mesothelial cells and fibroblasts prevent intra-abdominal adhesion formation in a rat model. J Tissue Eng Regen Med. 2016;10:855-866
  • 10. Moran M, Ozmen MM, Duzgun AP et al (2007) The effect of erythropoietin on healing of obstructive vs nonobstructive left colonic anastomosis: an experimental study. World J Emerg Surg 2:13–18, doi:10.1186/1749-7922-2-13.
  • 11. ling by operative lavage with nutrient solutions in experimental left-sided colonic obstruction. Br J Surg 82:461–464, doi:10.1002/bjs.1800820410
  • 12. Perju D, Târcoveanu E, Lupaşcu C (2005) Comparative experimental study of left colonic anastomoses in intestinal obstruction; the value of anastomoses protection with free peritoneal graft. Rev Med Chir Soc Med Nat Iasi 109:781–786.
  • 13. Hulkko OA, Haukipuro KA, Laitinen ST (1988) Fibrin glue protection of primary anastomosis in the obstructed left colon. An experimental study on the rat. Acta Chir Scand 154:49–52
  • 14. Erbil Y, Calis A, Berber E et al (2000) The effect of intraoperative colonic lavage with NG-nitro-L-arginine methyl ester (L-NAME) on anastomotic healing in the presence of left-sided colonic obstruction in the rat. Surg Today 30:421–425, doi:10.1007/ s005950050615
  • 15.Bourne GL (1960) The microscopic anatomy of the human amnion and chorion. Am J Obstet Gynecol 79:1070–1073
  • 16.Toda A, Okabe M, Yoshida T et al (2007) The potential of amniotic membrane/amnion-derived cells for regeneration of various tissues. J Pharmacol Sci 105:215–228, doi:10.1254/jphs. CR0070034
  • 17. Dua HS, Gomes JA, King AJ et al (2004) The amniotic membrane in ophthalmology. Surv Ophthalmol 49:51–77, doi:10.1016/j. survophthal.2003.10.004
  • 18. Talmi YP, Sigler L, Inge E et al (1991) Antibacterial properties of human amniotic membranes. Placenta 12:285–288, doi:10.1016/ 0143-4004(91)90010-D 19. RinastitiM, Harijadi, SantosoAL, SosrosenoW(2006)Histological evaluation of rabbit gingival wound healing transplanted with human amniotic membrane. Int J Oral Maxillofac Surg 35:247– 251, doi:10.1016/j.ijom.2005.09.012
  • 20. Tseng SC, Li DQ, Ma X et al (1999) Suppression of transforming growth factor-beta isoforms, TGF-beta receptor type II, and myofibroblast differentiation in cultured human corneal and limbal fibroblasts by amniotic membrane matrix. J Cell Physiol 179:325–335, doi:10.1002/(SICI)1097-4652(199906)179:3<325:: AID-JCP10>3.0.CO;2-X 21.
  • 21. Mermet I, Pottier N, Sainthillier JM et al (2007) Use of amniotic membranetransplantationinthetreatmentofvenouslegulcers.Wound Repair Regen 15:459–464, doi:10.1111/j.1524-475X.2007.00252.x
  • 22. UludagM, Citgez B, Ozkaya O,Yetkin G, Ozcan O, Polat N, Isgor A. Effects of the amniotic membrane on healing of colonic anastomoses in experimental left-sided colonic obstruction Langenbecks Arch Surg. 2010 Jun;395(5):535-43. doi: 10.1007/s00423-008-0443-y. Epub 2008 Dec 10.
  • 23. Barski D, Gerullis H, Ecke T, Varga G, Boros M, Pintelon I, Timmermans JP, Otto T. Human Amniotic Membrane Is Not Suitable for the Grafting of Colon Lesions and Prevention of Adhesions in a Xenograft Rat Model. Surg Innov. 2017 Aug;24(4):313-320. doi: 10.1177/1553350617709828. Epub 2017 May 26.
  • 24. Phillips JD, Kim JS, Fonkalsrud EW, Zeng H, Dindar Z. Effects of chronic corticosteroids and vitamin A on the healing of intestinal anastomoses. Am J Surg 1992;163(1):71 -7.
  • 25. Egger B, Inglin R, Zeek J, Dirsch O, Huang Y, Büchler WM. Insulin like growth factor I and truncated keratinocyte growth factor accelerate healing of left sided colonic anastomoses. Brit J of Surg. 2001;88(1):90–826.Kim JC, Tseng SC. Transplantation of preserved human amniotic membrane for surface reconstruction in severely damaged rabbit corneas. Cornea. 1995;14:473-484.
  • 27. Kesting MR, Loeffelbein DJ, Steinstraesser L, et al. Cryopreserved human amniotic membrane for soft tissue repair in rats. Ann Plast Surg. 2008;60:684-691.
  • 28. Kesting MR, Wolff KD, Mücke T, et al. A bioartificial surgical patch from multilayered human amniotic membrane: in vivo investigations in a rat model. J Biomed Mater Res B Appl Biomater. 2009;90:930-938.
  • 29. Uludag, M., Citgez, B., Ozkaya, O., Yetkin, G., Ozcan, O., Polat, N., & Isgor, A. (2009). Effects of amniotic membrane on the healing of normal and high-risk colonic anastomoses in rats. International journal of colorectal disease, 24(7), 809.
  • 30. Xing, L., Franz, M. G., Marcelo, C. L., Smith, C. A., Marshall, V. S., & Robson, M. C. (2007). Amnion-derived multipotent progenitor cells increase gain of incisional breaking strength and decrease incidence and severity of acute wound failure. Journal of burns and wounds, 7.
  • 31. Koizumi, N., Inatomi, T., Sotozono, C., Fullwood, N. J., Quantock, A. J., & Kinoshita, S. (2000). Growth factor mRNA and protein in preserved human amniotic membrane. Current eye research, 20(3), 173-177.

Year 2018, Volume: 40 Issue: 3, 291 - 298, 30.09.2018

Sinan Soylu , Zeynep Deniz Şahin İnan

https://doi.org/10.7197/223.vi.460562

Abstract

References

  • 1.Uludag M, Citgez B, Ozkaya O, Yetkin G, Ozcan O, Polat N, et al. Effects of amniotic membrane on the healing of primary colonic anastomoses in the cecal ligation and puncture model of secondary peritonitis in rats. Int J Colorectal Dis. 2009; 24(5): 559-67[DOI][PubMed]
  • 2.Kruschewski M, Rieger H, Pohlen U, Hotz HG, Buhr HJ. Risk factors for clinical anastomotic leakage and postoperative mortality in elective surgery for rectal cancer. Int J Colorectal Dis. 2007; 22(8): 919-27[DOI][PubMed]
  • 3. Nursal TZ, Anarat R, Bircan S, et al. The effect of tissue adhesive, octyl-cyanoacrylate, on the healing of experimental high-risk and normal colonic anastomoses. Am J Surg.2004;187:28–32.
  • 4. NasirKhan MU, Abir F, Longo W, et al. Anastomotic disruption after bowel resection. World J Gastroenterol. 2006;12(16):2497–2504.
  • 5.Zhou B, Ren J, Ding C, et al. Protection of colonic anastomosis with platelet-rich plasma gel in the open abdomen. Injury. 2014;45:864-868.
  • 6.Wenger FA, Szucsik E, Hoinoiu BF, Cimpean AM, Ionac M, Raica M. Circular anastomotic experimental fibrin sealant protection in deep colorectal anastomosis in pigs in a randomized 9-day survival study. Int J Colorectal Dis. 2015;30:1029-1039.
  • 7. Cueto J, Barrientos T, Rodriguez E, et al. Further experimental studies on a biodegradable adhesive for protection of colorectal anastomosis. Arch Med Res. 2014;45: 331-336.
  • 8. Hoare T, Yeo Y, Bellas E, Bruggeman JP, Kohane DS. Prevention of peritoneal adhesions using polymeric rheological blends. Acta Biomater. 2014;10:1187-1193
  • 9. Kawanishi K, Yamato M, Sakiyama R, Okano T, Nitta K. Peritoneal cell sheets composed of mesothelial cells and fibroblasts prevent intra-abdominal adhesion formation in a rat model. J Tissue Eng Regen Med. 2016;10:855-866
  • 10. Moran M, Ozmen MM, Duzgun AP et al (2007) The effect of erythropoietin on healing of obstructive vs nonobstructive left colonic anastomosis: an experimental study. World J Emerg Surg 2:13–18, doi:10.1186/1749-7922-2-13.
  • 11. ling by operative lavage with nutrient solutions in experimental left-sided colonic obstruction. Br J Surg 82:461–464, doi:10.1002/bjs.1800820410
  • 12. Perju D, Târcoveanu E, Lupaşcu C (2005) Comparative experimental study of left colonic anastomoses in intestinal obstruction; the value of anastomoses protection with free peritoneal graft. Rev Med Chir Soc Med Nat Iasi 109:781–786.
  • 13. Hulkko OA, Haukipuro KA, Laitinen ST (1988) Fibrin glue protection of primary anastomosis in the obstructed left colon. An experimental study on the rat. Acta Chir Scand 154:49–52
  • 14. Erbil Y, Calis A, Berber E et al (2000) The effect of intraoperative colonic lavage with NG-nitro-L-arginine methyl ester (L-NAME) on anastomotic healing in the presence of left-sided colonic obstruction in the rat. Surg Today 30:421–425, doi:10.1007/ s005950050615
  • 15.Bourne GL (1960) The microscopic anatomy of the human amnion and chorion. Am J Obstet Gynecol 79:1070–1073
  • 16.Toda A, Okabe M, Yoshida T et al (2007) The potential of amniotic membrane/amnion-derived cells for regeneration of various tissues. J Pharmacol Sci 105:215–228, doi:10.1254/jphs. CR0070034
  • 17. Dua HS, Gomes JA, King AJ et al (2004) The amniotic membrane in ophthalmology. Surv Ophthalmol 49:51–77, doi:10.1016/j. survophthal.2003.10.004
  • 18. Talmi YP, Sigler L, Inge E et al (1991) Antibacterial properties of human amniotic membranes. Placenta 12:285–288, doi:10.1016/ 0143-4004(91)90010-D 19. RinastitiM, Harijadi, SantosoAL, SosrosenoW(2006)Histological evaluation of rabbit gingival wound healing transplanted with human amniotic membrane. Int J Oral Maxillofac Surg 35:247– 251, doi:10.1016/j.ijom.2005.09.012
  • 20. Tseng SC, Li DQ, Ma X et al (1999) Suppression of transforming growth factor-beta isoforms, TGF-beta receptor type II, and myofibroblast differentiation in cultured human corneal and limbal fibroblasts by amniotic membrane matrix. J Cell Physiol 179:325–335, doi:10.1002/(SICI)1097-4652(199906)179:3<325:: AID-JCP10>3.0.CO;2-X 21.
  • 21. Mermet I, Pottier N, Sainthillier JM et al (2007) Use of amniotic membranetransplantationinthetreatmentofvenouslegulcers.Wound Repair Regen 15:459–464, doi:10.1111/j.1524-475X.2007.00252.x
  • 22. UludagM, Citgez B, Ozkaya O,Yetkin G, Ozcan O, Polat N, Isgor A. Effects of the amniotic membrane on healing of colonic anastomoses in experimental left-sided colonic obstruction Langenbecks Arch Surg. 2010 Jun;395(5):535-43. doi: 10.1007/s00423-008-0443-y. Epub 2008 Dec 10.
  • 23. Barski D, Gerullis H, Ecke T, Varga G, Boros M, Pintelon I, Timmermans JP, Otto T. Human Amniotic Membrane Is Not Suitable for the Grafting of Colon Lesions and Prevention of Adhesions in a Xenograft Rat Model. Surg Innov. 2017 Aug;24(4):313-320. doi: 10.1177/1553350617709828. Epub 2017 May 26.
  • 24. Phillips JD, Kim JS, Fonkalsrud EW, Zeng H, Dindar Z. Effects of chronic corticosteroids and vitamin A on the healing of intestinal anastomoses. Am J Surg 1992;163(1):71 -7.
  • 25. Egger B, Inglin R, Zeek J, Dirsch O, Huang Y, Büchler WM. Insulin like growth factor I and truncated keratinocyte growth factor accelerate healing of left sided colonic anastomoses. Brit J of Surg. 2001;88(1):90–826.Kim JC, Tseng SC. Transplantation of preserved human amniotic membrane for surface reconstruction in severely damaged rabbit corneas. Cornea. 1995;14:473-484.
  • 27. Kesting MR, Loeffelbein DJ, Steinstraesser L, et al. Cryopreserved human amniotic membrane for soft tissue repair in rats. Ann Plast Surg. 2008;60:684-691.
  • 28. Kesting MR, Wolff KD, Mücke T, et al. A bioartificial surgical patch from multilayered human amniotic membrane: in vivo investigations in a rat model. J Biomed Mater Res B Appl Biomater. 2009;90:930-938.
  • 29. Uludag, M., Citgez, B., Ozkaya, O., Yetkin, G., Ozcan, O., Polat, N., & Isgor, A. (2009). Effects of amniotic membrane on the healing of normal and high-risk colonic anastomoses in rats. International journal of colorectal disease, 24(7), 809.
  • 30. Xing, L., Franz, M. G., Marcelo, C. L., Smith, C. A., Marshall, V. S., & Robson, M. C. (2007). Amnion-derived multipotent progenitor cells increase gain of incisional breaking strength and decrease incidence and severity of acute wound failure. Journal of burns and wounds, 7.
  • 31. Koizumi, N., Inatomi, T., Sotozono, C., Fullwood, N. J., Quantock, A. J., & Kinoshita, S. (2000). Growth factor mRNA and protein in preserved human amniotic membrane. Current eye research, 20(3), 173-177.
There are 29 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Surgical Science Research Articles
Authors

Sinan Soylu

Zeynep Deniz Şahin İnan

Publication Date September 30, 2018
Acceptance Date September 18, 2018
Published in Issue Year 2018 Volume: 40 Issue: 3

Cite

AMA Soylu S, İnan ZDŞ. Effect of the wrapping of experimentally induced ischemic colonic anastomoses with the amniotic membrane on anastomosis safety in rats. CMJ. September 2018;40(3):291-298. doi:10.7197/223.vi.460562