Effects of Levosimendan on Anastomotic Healing in an Ischemic Colon Anastomosis Model

  • 1Department of Surgical Oncology, Ankara Sincan Training and Research Hospital, Sincan/Ankara, Turkey. Electronic address: seveneray@hotmail.com.
  • 2Department of General Surgery, Zonguldak Bülent Ecevit University Medical School, Zonguldak, Turkey.
  • 3Department of Medical Biochemistry, Zonguldak Bülent Ecevit University Medical School, Zonguldak, Turkey.
  • 4Department of Medical Pathology, Hitit University Medical School, Çorum, Turkey.
  • 5Department of Biostatistics, Zonguldak Bülent Ecevit University Medical School, Zonguldak, Turkey.

Abstract

INTRODUCTION

Anastomotic leakage following ischemic colon anastomosis poses significant morbidity and cost. Levosimendan, with inotropic and vasodilatory properties, may enhance healing. This study evaluated Levosimendan's effects on ischemic colon anastomosis in rats.

METHODS

Sixty Wistar Albino rats underwent ischemic colon anastomosis and were randomized into six groups: fourth-day control, seventh-day control, fourth-day low-dose Levosimendan, seventh-day low-dose Levosimendan, fourth-day high-dose Levosimendan, and seventh-day high-dose Levosimendan. Anastomotic bursting pressure, myeloperoxidase, hydroxyproline levels, and histopathological changes were assessed.

RESULTS

Levosimendan, particularly at low doses, significantly increased bursting pressure. The fourth-day low-dose group showed a median (Q1-Q3) bursting pressure of 98.00 (72.00-106.00) mmHg, compared to 53.00 (24.75-64.75) mmHg in the fourth-day control group (P = 0.001). The seventh-day low-dose group had a median (Q1-Q3) bursting pressure of 111.50 (96.50-154.00) mmHg, while the seventh-day control group had 91.00 (59.00-100.50) mmHg (P = 0.007). Histopathology revealed significant improvements in fibrosis (P = 0.020), ischemic necrosis (P < 0.001), and inflammatory cell infiltration in Levosimendan groups. Myeloperoxidase levels were significantly higher in the fourth-day low-dose group compared to the fourth-day control group (P = 0.041), while hydroxyproline levels showed no significant differences.

CONCLUSIONS

Levosimendan positively impacts ischemic colon anastomosis healing in rats, particularly at low doses.

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