The Effects of Perianastomotic Injections of Different Growth Factors on Experimental Colonic Anastomoses in Rats

Abstract

Aim: Despite advances in medicine and technology, anastomotic healing problems and leaks are still the most important causes of postoperative morbidity and mortality in colorectal surgery. Growth factors are proven to have significant effects on wound healing. The aim of the present study was to determine the effects of different growth factors on experimental colonic anastomoses and the healing process. Method: The study included 48 Wistar rats, weighting 200-250 g, which were divided to 6 randomised groups (n=8): Group I-Sham group; Group II-Partial colostomy+colonic anastomosis; Group III-Partial colostomy+colonic anastomosis+125 μg/kg epidermal growth factor; IV-Partial colostomy+colonic anastomosis+6.5 μg/kg keratinocyte growth factor; V-Partial colostomy+colonic anastomosis+16 μg/kg fibroblast growth factor; Group VI-Partial colostomy+colonic anastomosis +150 μg/kg granulocyte-colony stimulating factor. All factors were injected subserosally to the perianastomotic area. On the postoperative 7th day, rats were sacrificed and perianastomotic tissue examples were obtained for colonic bursting pressure, tissue hydroxyproline levels and histopathologic examination. Results: Colonic bursting pressures were higher in Groups III and V compared to Groups II and VI (p<0.01). Tissue hydroxyproline levels also were higher in Groups III, IV and V compared to Groups II and VI (p<0.001). Histopathologic examination revealed that the healing parameters were higher in Groups III, IV and V, and lesion parameters were higher in Groups II and VI. Conclusion: This study suggests that local application of epidermal, keratinocyte and fibroblast growth factors in the anastomotic area improves the healing process of colonic anastomoses.

Keywords

• Experimental
• healing
• colorectal