Şadiye Mehtat ÜNLÜ, Baha ASLAN, Süleyman Özkan AKSOY, Ali İbrahim SEVİNÇ, Mustafa Cem TERZİ, Hatice ŞİMŞEK KESKİN, Hilmi Feyzi ALANYALI

The effect of amniotic membrane wrapping on colorectal anastomosis in rats undergoing pelvic radiotherapy

Aim: This study aimed to investigate the effect of amniotic membrane wrapped onto the anastomosis line following colon resectionand primary anastomosis on anastomosis healing in rats undergoing pelvic radiotherapy.Material and Methods: Fifty-six male Wistar albino rats were randomly allocated to four main groups. Group I, left colon resection andprimary anastomosis; Group II, post-anastomotic amniotic membrane; Group III, preoperative radiotherapy; Group IV, preoperativeradiotherapy and amniotic membrane. Radiotherapy was administered under general anesthesia eight and four days prior to surgeryat a total of 20 Gy. In the first operation, all the rats underwent 1 cm left colon resection and primary anastomosis. The animals ineach group were anesthetized to assess the clinical, mechanical, histologic, and biochemical parameters of anastomotic healing onthe third and seventh postoperative days.Results: In the third day groups, anastomosis line bursting was observed in only one subject in those undergoing amniotic membranewrapping(p

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1. Cammà C, Giunta M, Fiorica F, et al. Preoperative radiotherapy for resectable rectal cancer: A metaanalysis. JAMA 2000;284:1008-15
2. Kuzu MA, Kuzu J, Köksoy C, et al. Histological evaluation of colonic anastomotic healing in the rat following preoperative 5-fluorouracil, fractionated irradiation and combined treatment. Int J Colorectal Dis 1998;13:235-40.
3. Dahlberg M, Glimelius B, Graf W, et al. Preoperative irradiation affects functional results after surgery for rectal cancer: results from a randomized study. Dis Colon Rectum 1998;41:543-51.
4. Meyerson RJ, Genovesi D, Lockett MA, et al. Five fractions of preoperative radiotherapy for selected cases of rectal carcinoma: long-term tumour control and tolerance to treatment. Int J Radiat Oncol Biol Phys 1999;43:537-43.
5. Birgisson H, Påhlman L, Gunnarsson U, et al. Late adverse effects of radiation therapy for rectal cancer - a systematic overview. Acta Oncol 2007;46:504-16.
6. Vignali A, Fazio VW, Lavery IC,et al. Factors associated with the occurrence of leaks in stapled rectal anastomoses: a review of 1014 patients. J Am Coll Surg 1997;185:105-13.
7. Eriksen MT,Wibe A, Norstein J, et al. Norwegian Rectal Cancer Group. Anastomotic leakage following routine mesorectal excision for rectal cancer in anational cohort of patients. Colorectal Dis 2005;7:51-7.
8. Branagan G, FinnesD.Wessex Colorectal Cancer Audit Working Group. Prognosis after anastomotic leakage in colorectal surgery. Dis Colon Rectum 2005;48: 1021-6.
9. Ha G, W Kim, JH Lee, et al. Oncologic Impact of Anastomotic Leakage Following Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis Ann Surg Oncol October 2017;24:3289-329.
10. Bourne GL The microscopic anatomy of the human amnion and chorion. Am J Obstet Gynecol 1960; 79:1070-3.
11. Rinastiti M, Harijadi SAL, Sosroseno W Histological evaluation of rabbit gingival wound healing transplanted with human amniotic membrane. Int J Oral Maxillofac Surg 2006;35:247-51.
12. Davis JW. Skin transplantation with a review of 550 cases at the Johns Hopkins Hospital. Johns Hopkins Med J 1910;15:307.
13. 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 2009 ;24:809-17.
14. Özçelik A, Yavuz E. Biyolojik Greft Materyalleri: Amnion Membran Grefti. Veteriner Cerrahi Dergisi 2006;12 :68-72
15. Weıber S, Jıborn H. Preoperative irradiation and colonic healing. European Journal of Surgery 1994:160:47- 51.
16. Terzi C, Sevinc AI, Kocdor H, et al: Improvement of colonic healing by preoperative rectal irrigation with short-chain fatty acids in rats given radiotherapy. Dis Colon Rectum 2004;47:2184-94.
17. De Roy van Zuidewein DB, Schillings PH, Wobbes T, et al.Histologic evaluation of wound healing in experimental intestinal anastomoses: effects of antineoplastic agents. Int J Exp Pathol1992;73:465-84.
18. Stevens KR, Fletcher W. Anterior resection and primary anastamozis following high dose preoperative irradiation for adenocarsinoma of the recto-sigmoid. Cancer, May 1978;41:2065-71.
19. Pucciarelli S1, Toppan P, Friso ML, et al. Preoperative combined radiotherapy and chemotherapy for rectal cancer does not affect early postoperative morbidity and mortality in low anterior resection.Dis Colon Rectum 1999;42:1276-83; discussion 1283-4.
20. Peeters KC, Tollenaar RA, Marijnen CA, et al. Dutch Colorectal Cancer Group. Risk factors for anastomotic failure after total mesorectal excision of rectal cancer. Br J Surg 2005;92:211-6.
21. Waninger J, Kauffmann GW, Shah IA, et al. Influence of the distance between interrupted sutures and the tension of sutures on the healing of experimental colonic anastomoses. Am J Surg 1992;163:319-23.
22. Turusov, RA Egorov, V.I. Stress State and Optimization of the Parameters of Interrupted and Machine Surgical Sutures of Human Intestine Mech Compos Mater 2019;55:405.
23. Barbul A. Wound healing. Surg Clin North Am,1997:509- 27.
24. Kuzu MA, Köksoy C. Effects of preoperative fractioned irradiation on left colonic anastamozis in the rat. Dis Colon Rectum, March 1998:41:370-6.
25. Hendriks T, Walter JB. Healing of experimental intestinal anastomoses. Dis Colon Rectum 1990:891- 901.
26. Wellwood JM, Jackson BT. The intestinal complications of radiotheraphy. British Journal of Surgery 1973:60:814-8.
27. Browder W, Williams D. Effect of enhanced macrofage function on early wound healing. Surgery 1988;104:224.
28. Olutoye OO, Yager DR. Lower cytokine release by fetal porcine platelets: A possible explanation for reduced inflammation after fetal wounding. J Pediatric Surgery 1996;31:91.
29. Kang NH, Yi BR, Lim SY, et al. Human amniotic membrane-derived epithelial stem cells display anticancer activity in BALB/c female nude mice bearing disseminated breast cancer xenografts. Int J Oncol 2012;40:2022-8.
30. Kim SH, Bang SH, Kang SY, et al. Human amniotic membrane-derived stromal cells (hAMSC) interact depending on breast cancer cell type through secreted molecules, Tissue Cell. 2015;47:10-6.