ACTA CHIRURGICA BELGICA, cilt.102, ss.33-36, 2002 (SCI İndekslerine Giren Dergi)
The leakage of colonic anastomoses increases perioperative morbidity significantly. The purpose of the study was to investigate the influence of neurotensin, an intestinal trophic peptide, on the healing of colonic anastomosis. Forty-two Wistar-albino rats were separated into three equal groups : Group 1 (control group) - segmental resection of the left colon and end-to-end anastomosis. Group 2 (dexamethasone group) - resection and anastomosis, plus 0.1 mg/kg/day of dexamethasone; Group 3 (neurotensin group) - same surgical procedure plus 300 pg/kg/day of neurotensin. Bursting pressure and tissue hydroxyproline content were determined as parameters of the anastomosis strength and healing on the 3(rd) and 7(th) days postoperatively. On the 31 day, mean bursting pressures were 141.4, 146.7 and 73.1 (p = 0.0001) cm of water in the control group, dexamethasone and neurotensin groups respectively. On the 7(th) day, bursting pressures were measured as 237.4, 100.6 (p = 0.0001) and 72.7(p = 10(-6)) cm of water, in the control group, dexamethasone and neurotensin groups respectively. Between the 3(rd) and 7(th) days, bursting pressures were increased significantly in the control group (p = 0.0001), decreased in the dexamethasone (p = 0.048), and maintained their lowest values in the neurotensin (p = 0.96) groups. On the 7(th) day, mean hydroxyproline levels were measured as 9.20, 3.30 (p = 0.007), 2.86 (p = 0.007) mug, in the control group, dexamethasone, and neurotensin groups respectively. Between the 3(rd) and 7(th) days, tissue hydroxyproline levels were increased significantly in the control group (p = 0.004), decreased in the dexamethasone (p = 0.03), and maintained their lowest values in the neurotensin (p = 0.87) groups. The anastomosis resistance to intraluminal pressure was weak, tissue collagen content was insufficient, and healing was inadequate in the dexamethasone and neurotensin groups in respect to the control group. We concluded that neurotensin impaired the healing, and affected the strength of the colonic anastomosis.