Güzin Yeşim Özgenel, Melekber ÇAVUŞ ÖZKAN, Betül TUNCEL

Topikal 5-fluorourasil uygulamasının epinörektomi yapılan sıçan siyatik sinir çevresinde epinöral skar dokusu oluşumu üzerine etkisi

Amaç: Çalışmamızda, topikal 5-fluorouracil (5–FU) uygulamasının periferik sinir cerrahisi sonrası sonucu olumsuz yönde etkileyen epinöral skar dokusu gelişimi üzerine etkisi ve ayrıca iki doz 5–FU uygulamanın sonucu değiştirip değiştirmeyeceği araştırılmıştır. Gereç ve Yöntem: Çalışmada 72 adet, 250-300 gr ağırlığında, 3 aylık dişi Sprague-Dawley tipi sıçanlar kullanılmıştır. Denekler bir haftalık gözlemi takiben sağlıklı olduklarına kanaat getirildikten sonra rastgele 3 ana gruba ayrıldı. Grup A: cilt kesisi + epinörektomi + izotonik (n=24). Grup B: cilt kesisi + epinörektomi • tek doz 5-FU (n=24). Grup C: cilt kesisi + epinörektomi + iki doz 5-FU (n=24). Her bir grup kendi içinde incelenen haftalar temel alınarak ikişer alt gruba ayrılmıştır. Her üç gruptaki denekler ikiye ayrılarak 4. ve 8. haftalarda yürüme testi, makroskobik ve histopatolojik incelemeler yapılmıştır. Bulgular: Makroskobik bulgular değerleğendirildiğinde siyatik sinir yapışıklığı ve dallarının ayrılabilirliğinde Grup A ve Grup C arasında istatiksel olarak anlamlı fark olup, Grup C’de daha iyi sonuçlar elde edilmiştir. Sonuç: Çalışmamızda, lokal 5-FU’in epinörektomi yapılan sinir etrafında oluşan skar dokusu gelişimi üzerine olumlu etkilere sahip olduğunu, bu olumlu etkinin sinir fonksiyonel kapasitesine de yansıdığını ve ikinci doz 5-FU uygulanmasının bu olumlu etkiyi pekiştirdiğini gösterdik.

The effect of topical 5-fluorouracil application on epineural scar tissue in epineurectomized rat sciatic nerve

Objective: This study investigated the effect of topical 5-fluorouracil (5-FU) application on the epineural scar tissue, which has a negative impact on the outcome after a peripheral nerve surgery, and whether the application of two doses of 5-FU would change the outcome.Materials and Methods: The study involved 72, 3-month-old female Sprague-Dawley rats weighing 250-300 g each. After the experimental animals were observed for a week to make certain that they were healthy, they were randomly divided into 3 main groups; Group A: skin incision + epineurotomy + isotonic solution (n=24), Group B: skin incision + epineurotomy + single dose of 5-FU (n=24) and Group C: skin incision + epineurotomy + two doses of 5-FU (n=24). Each group was divided into 2 subgroups based on the weeks in which they were examined. The two subgroups in each of the three groups were made subject to a walking test, and macroscopic and histopathological examinations at Week 4 and Week 8.Results: An evaluation of the macroscopic results showed that there was a statistically significant difference between Group A and Group C in sciatic nerve adhesion and severability of its branches. We obtained better results in Group C, when compared with the results obtained in Group A.Conclusion: We demonstrated in our study that 5-FU had a positive effect on the scar tissue developed around the epineurectomized nerve. This positive effect was also reflected in the nerve’s functional capacity, and a second dose of 5-FU application further improved this effect.

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