Influence of Preoperative Feeding on the Healing of Colonic Anastomoses in Malnourished Rats

• Published in: JPEN. Journal of parenteral and enteral nutrition Vol. 33; no. 1; pp. 83 - 89
• Main Authors: Gonçalves, Carolina Gomes, Groth, Anne Karoline, Ferreira, Marcelo, Matias, Jorge Eduardo F., Coelho, Júlio Cezar U., Campos, Antonio Carlos L.
• Format: Book Review Journal Article
• Language: English
• Published: Thousand Oaks, CA SAGE Publications 01-01-2009; Sage Publications
• Subjects: anastomoses; Anastomosis, Surgical; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Biological and medical sciences; Body Weight; Collagen - analysis; Colon - surgery; Diseases of the digestive system; Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition; Food; healing; Intensive care medicine; Male; Malnutrition; Medical sciences; perioperative care; Preoperative Care - methods; protein energy malnutrition; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rats; Rats, Wistar; Serum Albumin - analysis; Tensile Strength - physiology; Wound Healing - physiology; protein energy malnutrition; healing; anastomoses; rats; perioperative care; Nutrition; Rat; Digestive system; Gut; Rodentia; Nutrition disorder; Enteral administration; Parenteral administration; Feeding; Vertebrata; Mammalia; Animal; Colon; Preoperative; Malnutrition
• ISSN: 0148-6071; 1941-2444
• DOI: 10.1177/0148607108327047

Background: Malnutrition influences healing of gastrointestinal
anastomoses. The authors hypothesize that colonic anastomotic healing is
decreased by malnutrition and might be improved by preoperative feeding.
Methods: Eighty adult male Wistar rats were divided into 4 groups:
(1) control rats 1 (C1), fed regular chow ad libitum for 21 days; (2)
malnourished pair-fed rats (M), fed 50% of the food ingested by the control
rats for 21 days; (3) preoperative nutrition rats (PRE), fed 50% of the
average of the controls for 21 days and then fed preoperative nutrition with
regular chow ad libitum for 1 week before the operation; and (4) control rats
2 (C2), fed regular chow ad libitum for 28 days. On days 21 (C1 and M) and 28
(PRE and C2), rats underwent 2 colonic transections and, subsequently, 2
end-to-end anastomoses. Rats were killed on postoperative day 5. The
anastomoses were ressected for tensile strength and histological analysis.
Results: PRE rats showed increased maximal tensile strength vs the M
group (0.09 ± 0.01 vs 0.15 ± 0.01; P < .05) and
similar values of maximal tensile strength as the controls (0.15 ± 0.01
vs 0.15 ± 0.02; P = .91). Collagen type I was higher in
controls vs the PRE group (6.13 ± 0.39 vs 4.90 ± 1.53;
P < .05); nevertheless, the PRE group showed higher collagen type
I than M rats (4.90 ± 0.36 vs 3.83 ± 0.35; P < .05).
Conclusions: Preoperative feeding for 7 days increases the maximal
tensile strength, as well as the percentage area of mature collagen,
approaching similar values as the control group.