The effect of preoperative 5-fluorouracil on colonic healing: an experimental study

After curative resection for colorectal carcinoma there is a high recurrence rate and neoadjuvant chemotherapy may be useful in some patients. Very little is known about the effect of preoperative 5-fluorouracil on the healing of colon anastomosis. The aim of this study was to evaluate the effect of 5-fluorouracil on colonic healing when the time interval between the last injection and operation was shortened to 24 hours.

Thirty-six male Wistar rats with a median weight of 185 g (range: 165-200 g) were divided into three groups: 1) control group (n = 12); 2) sham group (n = 12) which received saline intraperitoneally, and 3) study group (n = 12) which received 5-fluorouracil intraperitoneally (20 mg/kg-1). All injections were given intraperitoneally for 5 days and the last dose was injected 24 hours before operation.

The mortality rate (22.7%) and anastomotic complications (29.4%) were increased in the 5-fluorouracil group, compared with the control or saline groups (P < 0.05). The anastomotic bursting pressure in rats having 5-fluorouracil treatment (27 mm Hg) was significantly lower from both the control (55 mm Hg) and saline (84 mm Hg) groups on postoperative day 3 (P < 0.05). Both myeloperoxidase and hydroxyproline contents were also significantly lower than the other groups (P < 0.05).

Colonic healing was impaired and mortality rate was increased when intraperitoneal 5-fluorouracil treatment was repeated until 24 hours before operation.