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Mehmet Dokur,Erdal Uysal 대한외과학회 2017 Annals of Surgical Treatment and Research(ASRT) Vol.93 No.1
Purpose: Postoperative intraperitoneal adhesions (PIAs) are one of the most important problems surgeons have to face after laparotomies. In this study, we aimed to evaluate the effectiveness of local application of botulinum toxin type A (BoNT-A) in various dosages on the prevention of intra-abdominal adhesions in rats with experimental intra-abdominal adhesions. Methods: Forty Wistar Albino female rats were randomly separated into 4 groups. The 4 groups were determined as follows: Control (group 1, n = 10); Sham (group 2, n = 10); 10-mg/kg low-dose BoNT-A (group 3, n = 10) and 30-㎎/㎏ highdose BoNT-A (group 4, n = 10). Subserosal injuries were created on the caecum of all rats. Laparotomy was performed on the fifth day. Adhesion scores, histopathological examination, and E-cadherin expression levels were evaluated. Results: General adhesion scores for groups 1 and 2 were determined to be significantly high when compared to group 4 (P < 0.001). A significant difference was also determined between groups 3 and 4 in terms of general adhesion scores (P < 0.05). In pair comparisons, a significant decrease in high-dose BoNT-A group (group 4) when compared to groups 1 and 2 in terms of neovascularization, fibroblast density, collagen deposition and inflammatory cell count was determined (P < 0.05). Conclusion: A significant decrease was observed only in postoperative PIAs in the high-dose BoNT-A group between all 4 rat-groups with experimentally created postoperative PIAs. In this study, high-dose BoNT-A is determined to be an effective agent in preventing postoperative PIAs.
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Comparison of effects of the tacrolimus and cyclosporine A on the colon anastomosis recovery of rats
Erdal Uysal,Mehmet Dokur 대한외과학회 2017 Annals of Surgical Treatment and Research(ASRT) Vol.92 No.6
Purpose: This study aims to examine and compare the effects of immunosuppressant cyclosporine A (CsA) and tacrolimus (TAC) on colon anastomosis recovery. Methods: Forty rats were randomly divided into 4 groups. The 4 groups were determined as follows: control group; sham group, given %0.09 NaCl; TAC group, given 0.5 mg/kg/day tacrolimus; and CsA group, given 5 mg/kg/day CsA. A 6-cm midabdomen incision was performed on the rats. An incision of all layers on the right colon was performed. Then anastomosis was undertaken. Laparotomy was performed on the seventh day postoperation. The colon bursting pressures were evaluated, histopathological examinations were undertaken, and E-cadherin expression and tissue hydroxyproline levels were evaluated. Results: Statistically significant differences were observed among bursting pressures of the groups (P < 0.001). The value was significantly low in TAC and CsA groups when compared to control and sham groups (P < 0.05). The tissue hydroxyproline levels were significantly low in TAC group compared to control group (P = 0.03). Fibroblast density and neovascularization were significantly greater in the control group compared to the TAC group (P < 0.05). Levels of collagen had decreased significantly in TAC group compared to other groups (P < 0.05). Conclusion: Our study showed that TAC may have a negative effect of colon anastomosis recovery. The lowest anastomosis bursting pressure was detected in TAC group. Also, collagen, hydroxyproline, fibroblast, neovascularization and E-Cadherin levels were comparatively lower in TAC group. CsA did not cause any significant changes to tissue hydroxyproline, collagen, fibroblast, and E-Cadherin levels.
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