Effects of Local and Systematic Administration of Adipose Tissue-Derived Stem Cells to Intestinal Anastomosis in...

Intestinal ischemia-reperfusion (IR) injury compromises anastomotic healing and may weaken anastomotic integrity. Adipose tissue-derived stem cells (AD-SCs) have been shown to enhance tissue regeneration through angiogenic and anti-ischemic effects. This study aimed to evaluate the impact of local and systemic AD-SC administration on anastomotic healing and strength following intestinal IR injury using histopathological parameters and bursting pressure measurements.

Thirty male Wistar Albino rats were randomly assigned to three groups (n = 10 each): control, local AD-SC, and systemic AD-SC. IR injury was induced by clamping the superior mesenteric artery, followed by intestinal resection and anastomosis. Local or systemic AD-SCs (1 × 10⁶ cells in 1.5 mL phosphate-buffered saline) were administered according to group allocation. On postoperative day 7, serum hydroxyproline levels, bursting pressures, and semiquantitative histological scores (ischemic necrosis, vascular proliferation, re-epithelialization, and collagen density) were assessed. Ordinal histological outcomes were analyzed using Kruskal-Wallis tests with Dunn's post hoc comparisons.

Six animals died before the end point, leaving 24 rats for analysis. Bursting pressures and serum hydroxyproline levels did not differ significantly among groups. However, systemic AD-SC administration significantly improved all histological parameters compared with the control group, exhibiting lower ischemic necrosis and higher vascular proliferation, re-epithelialization, and collagen density (P < 0.05 for each). Local AD-SCs produced intermediate improvements but did not differ significantly from controls in some parameters. Effect sizes indicated moderate to very large differences favoring systemic administration.

Systemic AD-SC administration enhanced multiple histological markers of anastomotic healing following intestinal IR injury, whereas local administration produced more modest effects. Although bursting pressures and serum hydroxyproline levels did not significantly differ, the histopathological findings suggest that systemic AD-SCs may provide a broader therapeutic benefit in promoting anastomotic integrity in ischemic bowel conditions. Further experimental studies incorporating direct leak outcomes are warranted.