Journal of Gastroenterology

, Volume 31, Issue 6, pp 777–784 | Cite as

Evaluation of omental implantation for perforated gastric ulcer therapy: Findings in a rat model

  • Yasunori Matoba
  • Hironori Katayama
  • Hiroshi Ohami
Alimentary Tract


Omental implantation, a surgical procedure in which a perforated gastric or duodenal ulcer is repaired by drawing and implanting a portion of the omentum into the digestive tract, accelerates ulcer healing and inhibits ulcer recurrence. However, the mechanisms underlying these beneficial effects are largely unknown. To clarify these mechanisms, we investigated ulcer healing in two groups of rats in which acetic acid-induced gastric ulcers were perforated. Omental implantation was used for repair in one group and simple suturing was employed in the other group. Greater antiinflammatory and angiogenic activity and accelerated collagen synthesis were seen in the omental implantation group. Basic fibroblast growth factor (bFGF)-mediated angiogenesis was noted in this group, as well as transforming growth factor-β1 (TGF-β1) activity within and around the omentum, resulting in abundant collagen production. It was confirmed that omental implantation accelerated ulcer healing and inhibited ulcer recurrence, and the presence of bFGF and TGF-β1 played a significant role in both these phenomena.

Key words

omental implantation omentum perforated gastro-duodenal ulcer ulcer recurrence growth factor 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Boey J, Wong J. Perforated duodenal ulcer. World J Surg 1984;11:319–324.Google Scholar
  2. 2.
    Skovgaad S. Late results of perforated duodenal ulcer treated by simple suture. World J Surg 1977;1:521–526.Google Scholar
  3. 3.
    Tsuchiya Y, Matsubayashi F, Hirai M, et al. Omental implantation on gastroduodenal perforations. Chir Gastroenterol (Surg Gastroenterol) 1979;13:235–243.Google Scholar
  4. 4.
    Hirai M. A study of omental implantation on benign gastroduodenal perforations (in Japanese with English abstract). Nichiidaishi (J Nippon Med School) 1981;48:623–631.Google Scholar
  5. 5.
    Takagi K, Okabe S, Saziki R. A new method for the production of chronic gastric ulcer in rats and the effect of several drugs on its healing. Jpn J Pharmacol 1969;19:418–426.PubMedGoogle Scholar
  6. 6.
    Monden T, Morimoto H, Nakanishi H, et al. A comparative immunohistochemical study of p53 and heat shock protein expression in microwave-fixed, paraffin-embedded sections of colorectal tumors. Acta Histochem Cytochem 1992;25:583–590.Google Scholar
  7. 7.
    Okabe S, Roth JLA, Pfeiffer CJ. A method for experimental, penetrating gastric and duodenal ulcers in rats. Am J Dig Dis 1971;16:277–284.CrossRefPubMedGoogle Scholar
  8. 8.
    Okabe S, Pfeiffer CJ. Chronicity of acetic acid ulcer in the rat stomach. Am J Dig Dis 1972;17:619–629.CrossRefPubMedGoogle Scholar
  9. 9.
    Fukawa K, Kawano O, Misaki N, et al. Experimental studies on gastric ulcer (6). Endoscopic evaluation of healing processes of acetic acid ulcer in rats (2): Healing, recurrence and relapse of ulcer (in Japanese with English abstract). Nihon Yakurigakkai Zasshi (Fol Pharmacol Jap) 1981;83:69–77.Google Scholar
  10. 10.
    Weiss SJ, Curnutte J, Regiani S. Neutrophil-mediated solubilization of the subendothelial matrix: Oxidative and nonoxidative mechanisms of proteolysis used by normal and chronic granulomatous disease phagocytes. J Immunol 1986;136:636–641.PubMedGoogle Scholar
  11. 11.
    Kandel J, Bossy-Wetzel E, Radvanyi F, et al. Neovascularization is associated with a switch to the export of bFGF in the multistep development of fibrosarcoma. Cell 1991;66:1095–1104.CrossRefPubMedGoogle Scholar
  12. 12.
    Nakamura T, Miller E, Ruoslahti E, et al. Production of extracellular matrix by glomerular epithelial cells is regulated by transforming growth factor-β1. Kidney Int 1992;41:1213–1221.PubMedGoogle Scholar
  13. 13.
    Cromack DT, Porras-Reyes B, Purdy JA, et al. Acceleration of tissue repair by transforming growth factorß1: Identification of in vivo mechanism of action with radiotherapy-induced specific healing defects. Surgery 1993;113:36–42.PubMedGoogle Scholar
  14. 14.
    Tiku K, Tiku ML, Skosey JL. Interleukin-1 production by human polymorphonuclear neutrophils. J Immunol 1986;136:3677–3685.PubMedGoogle Scholar
  15. 15.
    Dubravec DB, Spriggs DR, Mannick JA, et al. Circulating human peripheral blood granulocytes synthesize and secrete tumor necrosis factor α. Proc Natl Acad Sci USA 1990;87:6758–6761.PubMedGoogle Scholar
  16. 16.
    Bazzoni F, Cassatella MA, Rossi F, et al. Phagocytosing neutrophils produce and release high amounts of the neutrophilactivating peptide 1/interleukin-8. J Exp Med 1991;173:771–774.CrossRefPubMedGoogle Scholar
  17. 17.
    Cozzolino F, Torcia M, Aldinucci D, et al. Interleukin 1 is an autocrine regulator of human endothelial cell growth. Proc Natl Acad Sci USA 1990;87:6487–6491.PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • Yasunori Matoba
    • 1
  • Hironori Katayama
    • 2
  • Hiroshi Ohami
    • 3
  1. 1.Center for Digestive Diseases, Nippon Medical SchoolSecond HospitalKanagawaJapan
  2. 2.Department of Pathology, Nippon Medical SchoolTama-Nagayama HospitalTokyoJapan
  3. 3.Research Institute of GerontologyNippon Medical SchoolKanagawaJapan

Personalised recommendations