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The effect of N G-nitro L-arginine methyl ester on colonic anastomosis after increased intra-abdominal pressure

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Abstract

Background

Intestinal ischemia–reperfusion (I/R) is associated with augmented nitric oxide (NO) production. Increased intra-abdominal pressure (IAP) during surgical pneumoperitoneum (P) facilitates I/R injury. We previously demonstrated decreased strength and healing of colocolic anastomoses after high IAPs. The effect of an NO synthase inhibitor, N G-nitro-arginine methyl ester (l-NAME), on anastomoses realized in colonic tissue exposed to high IAPs was investigated in this study, a randomized, controlled, and experimental study with blind outcome assessment.

Method

Fifty Wistar–albino rats were randomized to five groups; all underwent colocolic anastomosis. P was maintained for 60 min at IAPs of 14, 20, 25, and 30 mmHg in study groups 1, 2, 3, and 4, respectively; P was preceded by intraperitoneal l-NAME (2.5 mg/kg) and followed by anastomosis. The control group was not subjected to IAP or l-NAME.

Results

Anastomosis bursting pressure (ABP) values and histopathological findings were determined on the 7th–14th postoperative days. The ABPs of groups 3–4 were significantly lower than the others. Groups 1–2 had results similar to controls. Histopathological findings of the groups were consistent with their ABPs.

Conclusion

Administration of a 2.5-mg/kg intraperitoneal l-NAME dose was found to provide a beneficial role, implying a role in impaired anastomotic healing after IAPs of 14 and 20 mmHg.

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Authors and Affiliations

  1. Department of Surgery, Afyon Kocatepe University, Afyonkarahisar, Turkey

    C. Polat, Y. Arıkan, G. Akbulut & S. Yilmaz

  2. Department of Internal Medicine, International Hospital, Istanbul, Turkey

    C. Gokce

  3. Department of Pathology, Afyon Kocatepe University, Afyonkarahisar, Turkey

    F. Aktepe

  4. Department of Surgery, Yeditepe University, Istanbul, Turkey

    O. Gokce

  5. Dumlupinar Mahallesi, Kamil Miras Caddesi, Lal Apt. No: 7/24, 03200, Afyonkarahisar, Turkey

    C. Polat

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  1. C. Polat
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  2. Y. Arıkan
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Correspondence to C. Polat.

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Polat, C., Arıkan, Y., Gokce, C. et al. The effect of N G-nitro L-arginine methyl ester on colonic anastomosis after increased intra-abdominal pressure. Langenbecks Arch Surg 392, 197–202 (2007). https://doi.org/10.1007/s00423-006-0088-7

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  • DOI: https://doi.org/10.1007/s00423-006-0088-7

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