Yusuf GÜNERHAN, BARLAS SULU, Barış ÖZTÜRK, Sevil Atalay VURAL, CELAL ŞAHİN ERMUTLU, AKSEM AKSOY, FATİH BÜYÜK

The effect of kefir on the healing of colonic anastomosis in rabbits

Bu çalışmada, deneysel olarak kolon anastomozu yapılan tavşanlarda kefirin iyileşme üzerine etkisi araştırıldı. Bu amaçla gerekli ön hazırlıkları yapılan ve ameliyat öncesi antibiyotik (AB) verilen toplam 16 tavşan, 8’erli iki gruba ayrıldı. Kontrol grubuna standart tavşan yemi ve su verilirken deney grubuna ameliyat öncesi ve sonrası beşer gün 30 ml/kg kefir standart yeme eklendi. Her iki grupta da assendens kolon rezeksiyonu ve uç uca anastomoz yapıldı. Ameliyat sonrası 5. gün anastomoz patlama basıncı ve bakteri translokasyonuna bakıldı. AyrVca, histopatolojik olarak değerlendirildi. Araştırma gruplarından alınan kan örneklerinde bakteri üremesi görülmezken hem deney hem kontrol grubunda birer tavşanda mezenter lenf bezinde bakteri üremesi tespit edildi. Deney grubunda anastomoz patlama basıncı ortalaması 133.75±25.03 mmHg, kontrol grubunda ise 85.0±17.5 mmHg olarak belirlenmiş ve gruplar arasındaki fark istatistiki olarak önemli bulundu (P

Anahtar Kelimeler:

cerrahi işlemler, kefir, histopatoloji, iyileşme, kültüre edilmiş süt, kolon, bakteriler, anastomoz, yeniden taşınma, tavşan

Kolon anastomozu yapılan tavşanlarda kefirin iyileşme üzerine etkisi

The present study was investigated the effect of kefir on anastomosis healing and bacterial translocation in rabbits with colonic anastomosis following colon preparation with laxative and antibiotic (AB) use. For this aim, 16 rabbits were divided into two groups each having 8 rabbits. All rabbits had prepared for surgery and received preoperative antibiotics. Control group received standard rabbit diet and water. The experimental group received 30 ml/kg kefir per day in addition to standard feeding, for 5 days before and after the operation. Right colonic resection and end-to-end anastomosis were done in both groups. Anastomosis bursting pressure and bacterial translocation were investigated on the fifth day after the operation. Also, histopathological evaluation was done. No bacterial growth was observed in blood cultures. However, mesenteric lymph node samples showed bacterial growth in two rabbits (one from each group). Mean anastomosis bursting pressure was 85.0±17.5 mmHg and 133.75±25.03 mmHg in the control and experimental group, respectively, with a statistically significant difference (P<0.01). Histopathological examination of the sections from the anastomosis sites revealed similar findings in both groups such as increased connective tissue proliferation and vascularisation. The increased bursting pressure in the experimental group particularly suggests that kefir may contribute to the healing of colonic anastomosis.

Keywords:

surgical operations, kefir, histopathology, healing, cultured milks, colon, bacteria, anastomosis, translocation, rabbits,

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Hesp FL, Hendriks T, Lubbers EJ, de Boer HH: Wound healing in the intestinal wall. A comparison between experimental ileal and colonic anastomoses. Dis Colon Rectum, 27, 99-104, 1984.
Thornton FJ, Barbul A: Healing in the gastrointestinal tract. Surg Clin North Am, 77, 549-575, 1997.
Matthiessen P, Hallböök O, Andersson M, Rutegård J, Sjödahl R: Risk factors for anastomotic leakage after anterior resection of the rectum. Colorectal Dis, 6, 462- 469, 2004.
Fielding LP, Stewart-Brown S, Blesovsky L, Kearney G: Anastomotic integrity after operations for large-bowel cancer: A multicentre study. Br Med J, 281 (6237): 411- 414, 1980.
Tümer AR, Kama NA, Tümer L, Reis E, Müftüoğlu S: Effects of 5-fluorouracil and zinc on healing of colonic anastomoses in rabbits. Eur J Surg, 165, 369-377, 1999.
Gökpınar I, Gürleyik E, Pehlivan M, Ozcan O, Ozaydın I, Aslaner A, Demiraran Y, Gültepe M: Early enteral and glutamine enriched enteral feeding ameliorates healing of colonic anastomosis: Experimental study. Ulus Travma Acil Cerrahi Derg, 12, 17-21, 2006.
Young HL, Wheeleer MH: Collagenase inhibition in the healing colon. J R Soc Med, 76, 32-36, 1983.
de Olivera PG, Soares EG, Aprilli F: Influence of misoprostol, a synthetic prostaglandin E1 analog, on the healing of colonic anastomoses in rats. Dis Colon Rectum, 37, 660-663, 1994.
Brennan SS, Foster ME, Morgan A, Leaper DJ: Prostaglandins in colonic anastomotic healing. Dis Colon Rectum, 27 (11): 723-725, 1984.
Vinderola G, Matar C, Perdigon G: Milk fermentation of L. helveticus R389 activate calcineurin as a signal to promote gut mucosal immunity. BMC Immunol, 7, 8-19, 2007.
Yüksekdağ ZN, Beyatlı Y: Kefir mikroflorasi ile laktik asit bakterilerinin metabolik, antimikrobiyal ve genetik özellikleri. Orlab On-Line Mikrobiyol Derg, 1, 49-69, 2003.
Kologlu M, Sayek I, Kologlu LB, Onat D: Effects of persistently elevated intraabdominal pressure on healing of colonic anastomoses. Am J Surg, 178, 293-297, 1999.
Luna, LG: Manual of Histologic Staining Methods. McGraw Hill Book Company, 1968.
Gunerhan Y, Koksal N, Gul O, Uzun MA, Gunes P, Adaleti R: The effect of unfractioned heparin and low moleculer weight heparin on colonic anastomosis in the presence of experimental peritonitis. Eur Sur Res, 38 (3): 353-357, 2006.
Sümbüloğlu K, Sümbüloğlu V: Biyoistatistik. Hatiboğlu Basım ve Yayım San., Ankara, 1998.
Pham M, Lemberg DA, Day AS: Probiotics: Sorting the evidence from the myths. Med J Aust, 188 (5): 304-308, 2008.
Atalan G, Demirkan I, Yaman H, Cihan M, Onder F, Sözmen M: Effect of topical kefir application on open wound healing: An in vivo study. Kafkas Univ Vet Fak Derg, 9, 43-47, 2003.
van Santvoort HC, Besselink MG, Timmerman HM, van Minnen LP, Akkermans LM, Gooszen HG: Probiotics in surgery. Surgery, 143, 1-7, 2008.
Servin Al: Antagonistic activities of lactobacilli and bifidobacteria against microbial pathogens. FEMS Microbiol Rev, 28, 405-440, 2004.
van Minnen LP, Timmerman HM, Lutgendorff F, Verheem A, Harmsen W, Konstantinov SR, Smidt H, Visser MR, Rijkers GT, Gooszen HG, Akkermans LM: Modification of intestinal flora with multispecies probiotics reduces bacterial translocation and improves clinical course in a rat model of acute pancreatitis. Surgery, 141 (4): 470-480, 2007.
Marco ML, Pavan S, Kleerebezem M: Towards understanding molecular modes of probiotic action. Curr Opin Biotechnol, 17, 204-210, 2006.
Otte JM, Podolsky DK: Functional modulation of enterocytes by gram-positive and gram-negative microorganisms. Am J Physiol Gastrointest Liver Physiol, 286, G613-626, 2004.
Niers LE, Timmerman HM, Rijkers GT, van Bleek GM, van Uden NO, Knol EF, Kapsenberg ML, Kimpen JL, Hoekstra MO: Identification of strong interleukin-10 inducing lactic acid bacteria which down-regulate T helper type 2 cytokines. Clin Exp Allergy, 35, 1481-1489, 2005.
Sugawara G, Nagino M, Nishio H, Ebata T, Takagi K, Asahara T, Nomoto K, Nimura Y: Perioperative synbiotic treatment to prevent postoperative infectious complications in biliary cancer surgery: A randomized controlled trial. Ann Surg, 244 (5): 706-714, 2006.
Seehofer D, Rayes N, Schiller R, Stockmann M, Müller AR, Schirmeier A, Schaeper F, Tullius SG, Bengmark S, Neuhaus P: Probiotics partly reverse increased bacterial translocation after simultaneous liver resection and colonic anastomosis in rats. J Surg Res, 117, 262-271,2004.
Gardiner KR, Erwin PJ, Anderson NH, Barr JG, Halliday MI, Rowlands BJ: Colonic bacteria and bacterial translocation in experimental colitis. Br J Surg, 80, 512- 516, 1993.
Mangiante G, Colucci GL, Gottin L, Casaril A, Ciola M, Facci E, Nicoli N: Effect of probiotic administration on colic anastomosis healing. Chir Ital, 53 (1): 39-44, 2001.