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Effects of amniotic membrane on the healing of normal and high-risk colonic anastomoses in rats

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Bacground

This study was aimed at examining whether or not the addition of amniotic membrane to a sutured colonic anastomosis improves its healing.

Material and methods

Ninety female Sprague Dawley rats were used in the study. Ten served as controls for bursting pressure measurement, while the other 80 animals were divided into four groups: Anastomosis group (NA), high-risk anastomosis group (HRA), anastomosis plus amniotic membrane group (NA-AM), and high-risk anastomosis plus amniotic membrane group (HRA-AM). The last two groups had amniotic membrane covering their anastomoses. Anastomotic evaluation was carried out on the third (NA3, HRA3, NA-AM3, and HRA-AM3, respectively) and seventh (NA7, HRA7, NA-AM7, and HRA-AM7, respectively) postoperative days. The main outcome measures were gross anastomotic healing, adhesion formation, mechanical strength, hydroxyproine content, and parameters of histopathological healing.

Results

Anastomotic dehiscence rate was 66.7%, 40%, 20%, and 10% in group HRA7, HRA3, NA7, and NA3, respectively. However, there was no significant difference between groups regarding the dehiscence rate. The adhesion scores were significantly higher in groups NA3 and HRA3 compared with groups NA-AM3 and HRA-AM3, respectively (p < 0.05, p < 0.001). Bursting pressure was significantly higher in groups with amniotic membrane compared without amniotic membrane (p < 0.05, for all comparison). Inflammatory cell infiltration was significantly lower in groups with amniotic membrane compared with groups without amniotic membrane (p < 0.05, for all both comparisons). Neoangiogenesis was significantly higher in the NA-AM3 and HRA-AM3 groups compared with the NA3 (p < 0.01) and HRA3 (p < 0.05) groups, respectively. Fibroblast activity was significantly higher in groups NA-AM3 and NA-AM7 compared with groups NA3 (p < 0.05) and NA7 (p < 0.05), respectively. Collagen deposition and hydroxyproline concentrations were significantly higher in groups with amniotic membrane compared with groups without amniotic membrane (p < 0.05, for all both comparisons).

Conclusion

The covering of both normal and high-risk colonic anastomoses with amniotic membrane provides a beneficial effect over conventional suturing of healing.

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Author information

Authors and Affiliations

  1. Second Department of General Surgery, Sisli Etfal Training and Research Hospital, Sisli, Istanbul, Turkey

    Mehmet Uludag, Bulent Citgez & Gurkan Yetkin

  2. Deparment of Plastic Reconstructive and Esthetic Surgery, Yalova Public Hospital, Yalova, Turkey

    Ozay Ozkaya

  3. Department of Biochemistry and Clinical Biochemistry, GATA Haydarpasa Training Hospital, Uskudar, Istanbul, Turkey

    Omer Ozcan

  4. Department of Pathology, Sisli Etfal Training and Research Hospital, Sisli, İstanbul, Turkey

    Nedim Polat

  5. Golden Horn University Health Sciences Institute, Aksaray, Istanbul, Turkey

    Adnan Isgor

  6. Atakent Mah. 3. Etap, Blok: D21/1, D:1, Kucukcekmece, Istanbul, 34303, Turkey

    Mehmet Uludag

Authors
  1. Mehmet Uludag
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  2. Bulent Citgez
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  3. Ozay Ozkaya
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  4. Gurkan Yetkin
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  7. Adnan Isgor
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Correspondence to Mehmet Uludag.

Additional information

This study was presented as an oral presentation in the 18th World Congress of the International Association of Surgeons, Gastroenterologists, and Oncologists.

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Uludag, M., Citgez, B., Ozkaya, O. et al. Effects of amniotic membrane on the healing of normal and high-risk colonic anastomoses in rats. Int J Colorectal Dis 24, 809–817 (2009). https://doi.org/10.1007/s00384-009-0691-5

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  • DOI: https://doi.org/10.1007/s00384-009-0691-5

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