Skip to main content

Advertisement

SpringerLink
Log in

Effects of perioperative hypothermia on healing of anastomosis of the colon in rats

  • Original Article
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Objective

We evaluated the hypothesis that induced perioperative hypothermia in rats causes adverse effects on the healing of colonic anastomosis.

Materials and methods

Forty-eight Wistar rats were divided into eight groups of six animals that underwent laparotomy, sigmoid section, and anastomosis. Four groups were operated under normothermic conditions (36 ± 1 °C) and four under hypothermic conditions (32 ± 1 °C). The reoperations were performed on days 3, 7, and 14 post-surgery, and two groups where SHAM reoperated on day 3. We evaluated anastomotic bursting pressure and tissue hydroxyproline content; performed a histological analysis of inflammatory parameters and healing (inflammatory cell infiltrate, edema, fibrin, collagen deposition and apoptotic cells) with categorization scores = 0, 1, 2, 3; and examined the relative quantification gene expression (cDNA) of inflammatory cytokines [interleukin 1 (IL-1), interleukin 6 (IL-6), and interleukin 10 (IL-10)] and growth factors [vascular endothelial growth factor and insulin-like growth factor 1 (IGF-1)] by reverse transcription polymerase chain reaction.

Results

Both of the hypothermic groups showed lower anastomotic burst pressure on days 7 and 14 post-surgery, reduced hydroxyproline content on day 14, reduction of inflammatory infiltrates and edema at day 3, and less collagen deposition on day 14. In animals that were hypothermic, the cytokine gene expression showed reduced IL-1 on day 3, reduced IL-6 on days 7 and 14, and reduced IL-10 on days 7 and 14 and a reduction in the growth factor IGF-1 on day 7.

Conclusion

Perioperative hypothermia had detrimental effects on the healing of colonic anastomosis in rats.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Rullier E, Laurent C, Garrelon JL, Michel P, Saric J, Parneix M (1998) Risk factors for anastomotic leakage after resection of rectal cancer. Br J Surg 85(3):355–358. doi:10.1046/j.1365-2168.1998.00615.x

    Article  PubMed  CAS  Google Scholar 

  2. Nesbakken A, Nygaard K, Lunde OC, Blucher J, Gjertsen O, Dullerud R (2005) Anastomotic leak following mesorectal excision for rectal cancer: true incidence and diagnostic challenges. Color Dis 7(6):576–581. doi:10.1111/j.1463-1318.2005.00870.x

    Article  CAS  Google Scholar 

  3. Matthiessen P, Hallbook O, Rutegard J, Simert G, Sjodahl R (2007) Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: a randomized multicenter trial. Ann Surg 246(2):207–214. doi:10.1097/SLA.0b013e3180603024

    Article  PubMed  Google Scholar 

  4. Tan WS, Tang CL, Shi L, Eu KW (2009) Meta-analysis of defunctioning stomas in low anterior resection for rectal cancer. Br J Surg 96(5):462–472. doi:10.1002/bjs.6594

    Article  PubMed  CAS  Google Scholar 

  5. Alves A, Panis Y, Trancart D, Regimbeau JM, Pocard M, Valleur P (2002) Factors associated with clinically significant anastomotic leakage after large bowel resection: multivariate analysis of 707 patients. World J Surg 26(4):499–502. doi:10.1007/s00268-001-0256-4

    Article  PubMed  Google Scholar 

  6. Haley RW, Culver DH, Morgan WM, White JW, Emori TG, Hooton TM (1985) Identifying patients at high risk of surgical wound infection. A simple multivariate index of patient susceptibility and wound contamination. Am J Epidemiol 121(2):206–215

    PubMed  CAS  Google Scholar 

  7. Golub R, Golub RW, Cantu R Jr, Stein HD (1997) A multivariate analysis of factors contributing to leakage of intestinal anastomoses. J Am Coll Surg 184(4):364–372

    PubMed  CAS  Google Scholar 

  8. Vignali A, Fazio VW, Lavery IC, Milsom JW, Church JM, Hull TL, Strong SA, Oakley JR (1997) Factors associated with the occurrence of leaks in stapled rectal anastomoses: a review of 1,014 patients. J Am Coll Surg 185(2):105–113

    PubMed  CAS  Google Scholar 

  9. Thornton FJ, Barbul A (1997) Healing in the gastrointestinal tract. Surg Clin North Am 77(3):549–573

    Article  PubMed  CAS  Google Scholar 

  10. Doufas AG (2003) Consequences of inadvertent perioperative hypothermia. Best Pract Res Clin Anaesthesiol 17(4):535–549

    Article  PubMed  Google Scholar 

  11. Reynolds L, Beckmann J, Kurz A (2008) Perioperative complications of hypothermia. Best Pract Res Clin Anaesthesiol 22(4):645–657

    Article  PubMed  Google Scholar 

  12. Kurz A, Sessler DI, Lenhardt R (1996) Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of wound infection and temperature group. N Engl J Med 334(19):1209–1215. doi:10.1056/NEJM199605093341901

    Article  PubMed  CAS  Google Scholar 

  13. Beilin B, Shavit Y, Razumovsky J, Wolloch Y, Zeidel A, Bessler H (1998) Effects of mild perioperative hypothermia on cellular immune responses. Anesthesiology 89(5):1133–1140

    Article  PubMed  CAS  Google Scholar 

  14. Greif R, Akca O, Horn EP, Kurz A, Sessler DI (2000) Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection. N Engl J Med 342(3):161–167. doi:10.1056/NEJM200001203420303

    Article  PubMed  CAS  Google Scholar 

  15. Carli F, Emery PW, Freemantle CA (1989) Effect of peroperative normothermia on postoperative protein metabolism in elderly patients undergoing hip arthroplasty. Br J Anaesth 63(3):276–282

    Article  PubMed  CAS  Google Scholar 

  16. Zubaidi A, Buie WD, Hart DA, Sigalet D (2010) Temporal expression of cytokines in rat cutaneous, fascial, and intestinal wounds: a comparative study. Dig Dis Sci 55(6):1581–1588. doi:10.1007/s10620-009-0931-0

    Article  PubMed  CAS  Google Scholar 

  17. Reddy GK, Enwemeka CS (1996) A simplified method for the analysis of hydroxyproline in biological tissues. Clin Biochem 29(3):225–229

    Article  PubMed  CAS  Google Scholar 

  18. Ignat’eva N, Danilov N, Averkiev S, Obrezkova M, Lunin V, Sobol E (2007) Determination of hydroxyproline in tissues and the evaluation of the collagen content of the tissues. J Anal Chem 62:51–57

    Article  Google Scholar 

  19. Salm R, Wullich B, Kiefer G, Fiebig HH, Farthmann EH (1991) Effects of a three-drug antineoplastic protocol of wound healing in rats: a biomechanical and histologic study on gastrointestinal anastomoses and laparotomy wounds. J Surg Oncol 47(1):5–11

    Article  PubMed  CAS  Google Scholar 

  20. Ehrlich HP, Tarver H, Hunt TK (1973) Effects of vitamin A and glucocorticoids upon inflammation and collagen synthesis. Ann Surg 177(2):222–227

    Article  PubMed  CAS  Google Scholar 

  21. Gonzalez-Pinto I, Gonzalez EM (2001) Optimising the treatment of upper gastrointestinal fistulae. Gut 49(Suppl 4):iv22–iv31

    PubMed  Google Scholar 

  22. Abbas MA (2010) Anastomotic leak: should we continue to accept the risks? Dis Colon Rectum 53(6):859–860. doi:10.1007/DCR.0b013e3181dcee11

    Article  PubMed  Google Scholar 

  23. Enoch S, Leaper DJ (2005) Basic science of healing. Surgery 23(2):37–42. doi:10.1383/surg.23.2.37.60352

    Google Scholar 

  24. Cheng YS, Yin FH, Foundling S, Blomstrom D, Kettner CA (1990) Stability and activity of human immunodeficiency virus protease: comparison of the natural dimer with a homologous, single-chain tethered dimer. Proc Natl Acad Sci U S A 87(24):9660–9664

    Article  PubMed  CAS  Google Scholar 

  25. Torossian A, Ruehlmann S, Middeke M, Sessler DI, Lorenz W, Wulf HF, Bauhofer A (2004) Mild preseptic hypothermia is detrimental in rats. Crit Care Med 32(9):1899–1903

    Article  PubMed  Google Scholar 

  26. Teke Z, Aytekin FO, Aydin C, Kabay B, Yenisey C, Sacar S, Simsek NG, Tekin K (2007) Effects of pyrrolidine dithiocarbamate on healing of colonic anastomoses in the cecal ligation and puncture model of intraperitoneal sepsis in rats. World J Surg 31(1):200–209. doi:10.1007/s00268-006-0013-9

    Article  PubMed  Google Scholar 

  27. Barbul A (2005) Wound healing, vol 1. Schwartz’s principles of surgery, 8th edn. McGraw-Hill, New York

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Health Sciences Center, Federal University of Santa Catarina (UFSC), Rua Prof. Maria Flora Pausewang, s/n, 88036-800 Trindade, Florianópolis, SC, Brazil

    João Carlos Costa de Oliveira

  2. University of Southern Santa Catarina (UNISUL), Palhoça, SC, Brazil

    Camila Helena de Oliveira & Henrique Eduardo de Oliveira

  3. Pathology Laboratory, Macro e Micro Anatomia Patológica, Florianópolis, SC, Brazil

    Gianfranco Luigi Colombeli

  4. Scientific Initiation Scholarship, Laboratory of Immunobiology, Department of Microbiology and Parasitology, Center for Biological Sciences, UFSC, Florianópolis, SC, Brazil

    Nicoli De Bona Heck

  5. Plant Morphogenesis and Biochemistry Laboratory, Center for Agricultural Sciences, UFSC, Florianopolis, SC, Brazil

    Aline Pereira

  6. Department of Surgery, Federal University of Santa Catarina, Florianopolis, SC, Brazil

    Armando José D’Acâmpora

Authors
  1. João Carlos Costa de Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Camila Helena de Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Henrique Eduardo de Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gianfranco Luigi Colombeli
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nicoli De Bona Heck
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Aline Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Armando José D’Acâmpora
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to João Carlos Costa de Oliveira.

Rights and permissions

Reprints and permissions

About this article

Cite this article

de Oliveira, J.C.C., de Oliveira, C.H., de Oliveira, H.E. et al. Effects of perioperative hypothermia on healing of anastomosis of the colon in rats. Int J Colorectal Dis 28, 705–712 (2013). https://doi.org/10.1007/s00384-013-1695-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-013-1695-8

Keywords

Search

Navigation