The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine

ASLANER, Arif; GÜNAL, Ömer; GHANDOURİ, Salah

The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine

Ömer GÜNAL, (Abant İzzet Baysal Üniversitesi, İzzet Baysal Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Bolu, Türkiye)

Salah GHANDOURİ, (Marmara Üniversitesi, Tıp Fakültesi, Psikoloji Anabilim Dalı, İstanbul, Türkiye)

Arif ASLANER (Abant İzzet Baysal Üniversitesi, İzzet Baysal Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Bolu, Türkiye)

Türkiye Klinikleri Tıp Bilimleri Dergisi

2 0

Yıl: 2005 Cilt: 25 Sayı: 5 Sayfa Aralığı: 653 - 657 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine

Öz:

Amaç: Kolorektal kanser rezeksiyonları sonrası lokal nükslerin önlenmesi için antikanser ajanlarla kolonun intraluminar olarak yıkanması, alternatif bir seçenektir. Her ne sebeple olursa olsun, herhangi bir ajanla kolon içinin yıkanması, anastomoz iyileşmesini etkileyebilir. Bu çalışma intrakolonik paklitaksel ve povidon iyot uygulamasının intestinal anastomoz iyileşmesine etkilerinin araştırılması için planlandı. Gereç ve Yöntemler: Her biri 10 sıçandan oluşan 2 gruba kolorektal anastomoz öncesi ve sonrasında paklitaksel (3 mg/kg) ve povidon iyot (%5) ile lokal kolon içi yıkama yapıldı. Kontrol grubu (n= 10) hiçbir medikal tedavi almadı. Anastomoz patlama basınçları, anastomoz hidroksiprolin içeriği ve perianastomotik miyeloperoksidaz (MPO) aktivitesi değerlendirildi. Bulgular: Patlama basıncı, kontrol grubuna göre povidon iyot grubunda belirgin olarak az iken, paklitaksel grubunda hafif artmış bulundu. Hidroksiprolin seviyesi, povidon iyot grubunda belirgin olarak artmış iken, paklitaksel grubunda azalmış bulundu. MPO seviyeleri, kontrol grubuna göre her 2 grupta da belirgin olarak azalmış olduğu bulundu. Sonuç: Paklitakselin hidroksiprolin üretimini azaltmasına rağmen, anastomoz patlama basıncını etkilemediği, buna karşın povidon iyotun hidroksiprolin sentezini arttırmasına rağmen anastomoz patlama basıncını azalttığı görüldü. Bu sonuçlarla, paklitaksel ve povidon iyotun etkilerini kollajen sentezinin miktar ve niceliğini değiştirerek sağladığı düşünüldü. Bu etkilerinin; her 2 grupta da MPO düzeylerinin düşük olması nedeni ile, inflamatuar yanıttan bağımsız olabileceği sonucuna varıldı.

Anahtar Kelime: Povidon-iyot Paklitaksel Kolorektal cerrahi İrrigasyon Kolon

Konular: Genel ve Dahili Tıp

Rektum içi paklitaksel yıkamasının rektum anastomozu iyileşmesi üzerine etkisi: Povidon iyot ile karşılaştırma

Öz:

Objective: Intraluminal colonic washout with anticancer agents is an alternative option to prevent local recurrences after colorectal cancer resection. However, intracolonic washout with any agent can interfere with anastomotic wound healing. The current study aimed to investigate the effects of intracolonic paclitaxel and povidone-iodine administration on intestinal anastomotic healing. Material and Methods: Localized intracolonic washout with paclitaxel (3 mg/kg) and povidone iodine (5%) was achieved before and after colorectal anastomosis in two (each consisting of 10) groups of rats. The control group (n= 10) received no medical therapy. Anastomotic bursting pressures, anastomotic hydroxyproline content, and peri anastomotic myeloperoxidase activity were determined. Results: Bursting pressure was significantly less in the povidone group, while it was slightly elevated in the paclitaxel group when compared to the control group. The hydroxyproline level was significantly increased in the povidone group, while it was found to be decreased in the paclitaxel group. Myeloperoxidase levels were also significantly decreased in both groups when compared to the control group. Conclusion: Although paclitaxel decreases hydroxyproline production, it does not appear to affect anastomotic bursting pressure. Conversely, povidone iodine decreases anastomotic bursting pressure despite increased hydroxproline synthesis. These data imply that paclitaxel and povidone iodine carry out their effects on anastomotic healing either by altering the quality or quantity of collagen synthesis.

Anahtar Kelime: Irrigation Colon Povidone-Iodine Paclitaxel Colorectal Surgery

Konular: Genel ve Dahili Tıp

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Bibliyografik

1. Landis SH, Murray T, Bolden S, Wingo PA. Cancer statistics. CA Cancer J Clin 1998;48:6-29.
2. Shukla HS, Hughes LE, Davis PW, Whitehead RH, Leach KG. Distribution of 5-FU to body tissues compared after intraluminal, intravenous and intramural administration in gastrointestinal cancer. Am J Surg 1977; 133:46-50.
3. Jenner DC, de Boer WB, Clarke G, Levitt MD. Rectal washout eliminates exfoliated malignant cells. Dis Colon Rectum 1998;41:1432-4.
4. Basha G, Penninckx F, Mebis J, Geboes K, Yap P. Prevention of anastomotic tumour take byyon-table colon washout with povidone-iodine, an experimental study in rats. Eur Surg Res 1999;31:202-9.
5. Rosin RD, Exarchakos G, Gilmore OJ, Ellis H. Topical noxythiolin in colonic healing. Br J Surg 1978;65:603-6.
6. Horwitz SB. Taxol (paclitaxel): Mechanisms of action. Ann Oncol 1994;5(Suppl 6):S3-6.
7. Sheppard BC, Rutten MJ, Meichsner CL, et al. Effects of paclitaxel on the growth of normal, polyposis, and cancerous human colonic epithelial cells. Cancer 1999;85:1454-64.
8. Reddy GK, Enwemeka CS. A simplified method for the analysis of hydroxyproline in biological tissues. Clin Biochem 1996;29:225-9.
9. Gulluoglu BM, Kurtel H, Gulluoglu MG, et al. Role of endothelins in trinitrobenzene sulfonic acid-induced colitis in rats. Digestion 1999;60:484-92.
10. Basha G, Penninckx F, Mebis J, Filez L, Geboes K, Yap P. Local and systemic effects of intraoperative wholecolon washout with 5 per cent povidone-iodine. Br J Surg 1999;86:219-26.
11. Erbil Y, Çalış A, Berber E, Mercan S. The effect of intraoperative colonic lavage with NG-nitro-L-arginine methyl ester (L-NAME) on anastomotic healing in the presence of left-sided colonic obstruction in the rat. Surg Today 2000;30:421-5.
12. Single-stage treatment for malignant left-sided colonic obstruction: A prospective randomized clinical trial comparing subtotal colectomy with segmental resection following intraoperative irrigation. The SCOTIA Study Group. Subtotal Colectomy versus On-table Irrigation and Anastomosis. Br J Surg 1995;82:1622-7.
13. Dudley HA, Radcliffe AG, McGeehan D. Intraoperative irrigation of the colon to permit primary anastomosis. Br J Surg 1980;67:80-1.
14. Foster ME, Johnson CD, Billings PJ, Davies PW, Leaper DJ. Intraoperative antegrade lavage and anastomotic healing in acute colonic obstruction. Dis Colon Rectum 1986;29:255-9.
15. Pollock AV, Playforth MJ, Evans M. Peroperative lavage of the obstructed left colon to allow safe primary anastomosis. Dis Colon Rectum 1987;30:171-3.
16. Pahlman L. Open trials in colorectal cancer. Eur J Surg Oncol 1995;21:347-51.
17. de Waard JW, Wobbes T, de Man BM, van der Linden CJ, Hendriks T. The effects of 5-fluorouracil and interferon-a on early healing of experimental intestinal anastomoses. Br J Cancer 1996;74:711-6.
18. de Waard JW, Wobbes T, de Man BM, van der Linden CJ, Hendriks T. Postoperative levamisole may compromise early healing of experimental intestinal anastomoses. Br J Cancer 1995;72:456-60.
19. Rowinsky EK, Cazenave LA, Donehower RC. Taxol: A novel investigational antimicrotubule agent. J Natl Cancer Instl990;82:1247-59.
20. Valenti AM, Niero A, Monti G, Marangolo F, Marangolo M. Paclitaxel and N-methylformamide: In vitro interactions in human colon cancer cell line. Anticancer Res 1997;17:2491-7.
21. Carrico TJ, Mehrhof AI, Cohen IK. Biology of wound healing. Surg Clin North Am 1984;64:721-33.
22. Hopkins MP, von Gruenigen VE, Holda S, Weber B. The effect of intermittent release intraperitoneal chemotherapy on wound healing. Am J Obstet Gynecol 1997;176:819-23.

APA	GÜNAL Ö, GHANDOURİ S, ASLANER A (2005). The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine. , 653 - 657.
Chicago	GÜNAL Ömer,GHANDOURİ Salah,ASLANER Arif The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine. (2005): 653 - 657.
MLA	GÜNAL Ömer,GHANDOURİ Salah,ASLANER Arif The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine. , 2005, ss.653 - 657.
AMA	GÜNAL Ö,GHANDOURİ S,ASLANER A The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine. . 2005; 653 - 657.
Vancouver	GÜNAL Ö,GHANDOURİ S,ASLANER A The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine. . 2005; 653 - 657.
IEEE	GÜNAL Ö,GHANDOURİ S,ASLANER A "The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine." , ss.653 - 657, 2005.
ISNAD	GÜNAL, Ömer vd. "The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine". (2005), 653-657.

APA	GÜNAL Ö, GHANDOURİ S, ASLANER A (2005). The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine. Türkiye Klinikleri Tıp Bilimleri Dergisi, 25(5), 653 - 657.
Chicago	GÜNAL Ömer,GHANDOURİ Salah,ASLANER Arif The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine. Türkiye Klinikleri Tıp Bilimleri Dergisi 25, no.5 (2005): 653 - 657.
MLA	GÜNAL Ömer,GHANDOURİ Salah,ASLANER Arif The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine. Türkiye Klinikleri Tıp Bilimleri Dergisi, vol.25, no.5, 2005, ss.653 - 657.
AMA	GÜNAL Ö,GHANDOURİ S,ASLANER A The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine. Türkiye Klinikleri Tıp Bilimleri Dergisi. 2005; 25(5): 653 - 657.
Vancouver	GÜNAL Ö,GHANDOURİ S,ASLANER A The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine. Türkiye Klinikleri Tıp Bilimleri Dergisi. 2005; 25(5): 653 - 657.
IEEE	GÜNAL Ö,GHANDOURİ S,ASLANER A "The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine." Türkiye Klinikleri Tıp Bilimleri Dergisi, 25, ss.653 - 657, 2005.
ISNAD	GÜNAL, Ömer vd. "The effect of intrarectal paclitaxel lavage on the healing of rectal anastomosis: A comparison with povidone lodine". Türkiye Klinikleri Tıp Bilimleri Dergisi 25/5 (2005), 653-657.