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Does becaplermin (platelet-derived growth factor-BB) reverse detrimental effects of ischemia on colonic anastomosis?
Kaya Saribeyoğlu1, Bilgi Baca, Ismail Hamzaoğlu
1Department of General Surgery, Cerrahpasa Medical School, Istanbul University, 5.Kisim, Ataköy, 34750 Istanbul, Turkey.
Purpose:
The aim of this study was to evaluate the effects of becaplermin on normal and ischemic colon anastomoses.
Methods:
Forty adult male Wistar-Albino rats were divided into four equal groups of ten. All rats underwent standard left colon resection and end-to-end anastomosis. The groups were as follows: Group 1, normal anastomosis alone; Group 2, ischemic anastomosis alone; Group 3, normal anastomosis and becaplermin therapy; and Group 4, ischemic anastomosis and becaplermin therapy. All animals were killed on postoperative Day 4. Intra-abdominal adhesions were scored, and anastomotic healing was evaluated with both in situ bursting pressure and hydroxyproline levels.
Results:
According to bursting pressure results, there was a significant difference between Group 2 and Group 4 (P < 0.05), but there was no statistically significant difference between Group 1 and Group 3 (P > 0.05). Hydroxyproline values revealed no statistically significant difference among any of the groups (P > 0.05). With regard to intra-abdominal adhesion scores, Group 3 had significantly lower values than Group 2 and Group 4 (P < 0.05). No statistically significant difference was observed between the other groups.
Conclusions:
Detrimental effects of ischemia on colonic anastomotic healing were reversed with becaplermin therapy. However, there was no such benefit on nonischemic anastomoses. Intra-abdominal application of this gel did not lead to an increase in intra-abdominal adhesion formation.
