İskemik kolon anastomoz iyileşmesinde syringic acid etkisi
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Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Kolorektal malignite, kanama, obtrüksiyon, travma gibi nedenler sonrası acil veya elektif şartlarda operasyona alınan hastalarda bağırsak rezeksiyonu ve anastomoz yapılabilmektedir. Kolon anastomozunun postoperatif dönemde ayrılma veya ayrışması; mortalite ve morbiditeyi arttıran en önemli komplikasyondur. Çalışmamızda amacımız iskemi / reperfüzyon hasarı olan reperfüze sıçan modelinde doğal antioksidan olan Syringic acid(SA)'in kolon anastomozuna etkisini göstermektir. Deney modeline göre 24 adet aynı özelliklerde aynı çevre koşullarında bulunan ratlar 12'şerli iki gruba ayrıldı. Tüm ratlara anestezi, antisepsi sonrası orta hat insizyonu yapıldı. Süperior mezenter arter ve kollateral damarlar aortanın distalinden mikrovasküler bir klemp kullanılarak 45 dakika klemplendi sonra klempler açılarak reperfüzyon için 45 dakika izin verildi. Tüm ratlara peritoneal refleksiyonun 3 cm proksimalinde sol kolon segmentinde tam kat insizyon yapılarak 6/0 monoflaman propilen suturlar ile tek tek anastomoz yapıldı. Birinci gruba günde 1 kez 0,5 cc intraperitoneal saline, ikinci gruba günde 1 kez 10 mg/kg 0.5 cc intraperitoneal Syringic Acid 5 gün boyunca uygulandı. Postoperatif 6. gün daha önce oluşturulan medyan kesi üzerinden batın içine girilerek anastomoz hattı ikişer santimetre proksimal ve distal bölgesi ile beraber rezeke edildi. İntrakardiyak kan ponksiyonu ile tüm ratlar sakrifiye edildi. Alınan anastomoz bölgesinde klinik iyileşme tayini için patlama basınçları ölçüldü. İntrakardiyak ponksiyon ile alınan kan örneklerinden biyokimyasal inceleme yapıldı. Deney grubunda patlama basınçları kontrol grubuna göre anlamlı olarak yüksek bulundu. Biyokimyasal incelemede; katalaz, nitrik oksit, glutatyon, redüktaz, Superoksid Dismutaz, TNF?, IL-6, AST, ALT, Hidroksiprolin, Miyeloperoksidaz, Malondialdehit, Kaspaz-3 düzeyleri ölçüldü. Beklenilenin aksine deney grubunda malondialdehit ve TNF-? anlamlı olarak yüksek bulunurken, glutatyon redüktaz düşük bulunmuştur. Syringic acid; farklı dozlar ve farklı deney modelleri kullanılarak yapılacak yeni bir çalışmalar ile pratikte kullanıma daha da yaklaşılabilir. Anahtar Kelimeler: İskemik kolon anastomozu, anastomoz kaçağı, Syringic acid
Intestinal resection and anastomosis can be performed in patients undergoing emergency or elective surgery after colorectal malignancy, bleeding, obstruction, trauma. Separation of the colon anastomosis in the postoperative period is the most important complication that increases mortality and morbidity. Purpose of this study is to show the effect of natural antioxidant Syringic acid(SA) on colon anastomosis in a reperfused rat model with ischemia/reperfusion injury. According to the experimental model, rats were randomly assigned to 2 groups of 12 rats each. A midline incision was performed in all rats after anesthesia and antisepsis. After laparotomy the superior mesenteric artery and collateral vessels were occluded from the distal aorta for 45 minutes with a microvascular clamp, then the clamps were released and a 45 minutes of reperfusion was allowed. In all rats, transection was made in the left colon segment 3 cm proximal to the peritoneal reflection and anastomosis was performed with single layer interrupted sutures of 6/0 monofilament propylene. The first group was given 0.5 cc intraperitoneal saline once a day, and the second group was given 10 mg/kg 0.5 cc intraperitoneal Syringic Acid once a day for 5 days. On the 6th postoperative day, the anastomosis line was resected together with the proximal and distal regions of 2 cm each, by entering the abdomen through the median incision created earlier. All rats were sacrificed by intracardiac blood puncture. Bursting pressures were measured to determine clinical improvement in the removed anastomosis site. Biochemical analysis was done from blood samples taken by intracardiac puncture. Burst pressures in the experimental group were found to be significantly higher than in the control group. In biochemical examination; Catalase, nitric oxide, glutathione, reductase, Superoxide Dismutase, TNF?, IL-6, AST, ALT, Hydroxyproline, Myeloperoxidase, Malondialdehyde, Caspase-3 levels were measured. In the experimental group, malondialdehyde and TNF-? were found to be significantly higher and glutathione reductase was found to be low. With new researches that will use different doses and different experimental models, the daily use of Syringic acid can be approached even more. Keywords: Ischemic colon anastomosis, anastomotic leakage, Syringic acid
Intestinal resection and anastomosis can be performed in patients undergoing emergency or elective surgery after colorectal malignancy, bleeding, obstruction, trauma. Separation of the colon anastomosis in the postoperative period is the most important complication that increases mortality and morbidity. Purpose of this study is to show the effect of natural antioxidant Syringic acid(SA) on colon anastomosis in a reperfused rat model with ischemia/reperfusion injury. According to the experimental model, rats were randomly assigned to 2 groups of 12 rats each. A midline incision was performed in all rats after anesthesia and antisepsis. After laparotomy the superior mesenteric artery and collateral vessels were occluded from the distal aorta for 45 minutes with a microvascular clamp, then the clamps were released and a 45 minutes of reperfusion was allowed. In all rats, transection was made in the left colon segment 3 cm proximal to the peritoneal reflection and anastomosis was performed with single layer interrupted sutures of 6/0 monofilament propylene. The first group was given 0.5 cc intraperitoneal saline once a day, and the second group was given 10 mg/kg 0.5 cc intraperitoneal Syringic Acid once a day for 5 days. On the 6th postoperative day, the anastomosis line was resected together with the proximal and distal regions of 2 cm each, by entering the abdomen through the median incision created earlier. All rats were sacrificed by intracardiac blood puncture. Bursting pressures were measured to determine clinical improvement in the removed anastomosis site. Biochemical analysis was done from blood samples taken by intracardiac puncture. Burst pressures in the experimental group were found to be significantly higher than in the control group. In biochemical examination; Catalase, nitric oxide, glutathione, reductase, Superoxide Dismutase, TNF?, IL-6, AST, ALT, Hydroxyproline, Myeloperoxidase, Malondialdehyde, Caspase-3 levels were measured. In the experimental group, malondialdehyde and TNF-? were found to be significantly higher and glutathione reductase was found to be low. With new researches that will use different doses and different experimental models, the daily use of Syringic acid can be approached even more. Keywords: Ischemic colon anastomosis, anastomotic leakage, Syringic acid
Açıklama
Tıp Fakültesi, Genel Cerrahi Ana Bilim Dalı
Anahtar Kelimeler
Genel Cerrahi, General Surgery
