Effects of hemoperitoneum on wound healing and fibrinolytic activity in colonic anastomosis

• Published in: Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES Vol. 18; no. 4; pp. 283 - 288
• Main Authors: Köksal, Neşet, Uzun, Mehmet Ali, Ozkan, Omer Faruk, Kayahan, Münire, Ipçioğlu, Osman Metin, Günerhan, Yusuf, Ergün, Ersin, Güneş, Pembegül
• Format: Journal Article
• Language: English
• Published: Turkey 01-07-2012
• Subjects: Anastomosis, Surgical; Animals; Colon - surgery; Female; Fibrinolysis - physiology; Hemoperitoneum - physiopathology; Rats; Rats, Wistar; Wound Healing - physiology
• ISSN: 1306-696X; 1307-7945
• DOI: 10.5505/tjtes.2012.65289

We aimed to test whether hemoperitoneum has adverse effects on colonic anastomosis healing by increasing fibrinolytic activity.
After colonic intersection and anastomosis, 20 Wistar Albino rats received intraabdominal injections of either 25 mg/kg blood (10, Group 1) or physiologic saline (10, Group 2). Anastomotic bursting pressures were measured after sacrifice on the fifth day. Following histopathological evaluation of the anastomotic line, hydroxyproline, tissue plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1), and tPA/PAI-1 complex levels were determined in the omentum, lung and anastomotic colon.
Mean anastomotic bursting pressures of Groups 1 and 2 were 224.5 mmHg and 254.4 mmHg (p=0.121), and mean hydroxyproline levels were 45.89 and 65.959 mg/g protein, respectively (p=0.257). Histopathology was insignificant. There was a significant difference between groups in omental tPA levels (0.962 ng/ml and 0.27 ng/ml, p=0.041), but not in PAI-1 and tPA/PAI-1. Anastomotic line and lung levels of tPA, PAI-1 and tPA/PAI-1 complex were not significantly different between groups. The relation between anastomotic line tPA level and bursting pressure was highly significant in Group 2 (r=0.778; p=0.008).
In this first study on the effect of hemoperitoneum on colonic anastomosis, we observed no significant effect on anastomotic healing or fibrinolytic activity, except in the omentum. Further studies with different blood volumes and assessment times are needed.