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The effects of octreotide on healing of small bowel anastomosis
S K Miller1, R G Martindale, X X Gao
1Department of Surgery, Eisenhower Army Medical Center, Augusta, Georgia, USA.
Abstract:
Octreotide (OCT) is a somatostatin analog used for its inhibitory action on multiple GI functions. Although octreotide has numerous clinical benefits, it has also been shown to inhibit postresectional hyperplasia of small bowel and hepatic regeneration. Because octreotide inhibits both trophic and anabolic hormones, we hypothesize that the use of octreotide may be detrimental in patients with a recent bowel anastomosis. To test this hypothesis, 60 male rats were randomized to four equal groups following small bowel anastomosis. Group I = control; Group II = 10 mg/day of hydrocortisone succinate; Group III = 2.5 micrograms/kg/day octreotide (equivalent of a clinical dose); Group IV = 25 micrograms/kg/day octreotide. Hydrocortisone was used as a negative control because it is known to have inhibitory effects on small bowel anastomotic healing. On postoperative Day 7, bursting pressures were measured. Serum T-kininogen levels, as a marker for systemic inflammation, and hydroxyproline content from the anastomotic segments were obtained. These results indicate that in the rat small bowel model, octreotide did not have any deleterious effect on anastomotic strength, systemic inflammation, and collagen content, even at high doses. Hydrocortisone, as expected, showed significant detrimental effects on bursting strength, as well as decreasing systemic inflammation. These findings have significant clinical implications, as octreotide could be used without jeopardizing the intestinal anastomosis.
Insights
Octreotide (OCT), a somatostatin analog, did not harm small bowel anastomosis healing in rats. This study suggests OCT can be safely used in patients with recent bowel anastomoses, without compromising healing.
Area of Science:
- Gastroenterology
- Surgical Research
- Pharmacology
Background:
- Octreotide (OCT), a somatostatin analog, inhibits gastrointestinal functions.
- OCT can impede small bowel hyperplasia and hepatic regeneration.
- Potential negative impact of OCT on bowel anastomosis healing is a clinical concern.
Purpose of the Study:
- To investigate the effects of octreotide on small bowel anastomotic healing in a rat model.
- To determine if octreotide administration compromises anastomotic strength, systemic inflammation, or collagen content.
- To assess the safety of octreotide in the context of recent bowel anastomosis.
Main Methods:
- 60 male rats underwent small bowel anastomosis and were divided into four groups: control, hydrocortisone, low-dose octreotide, and high-dose octreotide.
- Postoperative assessment included measuring bursting pressures of anastomotic segments on Day 7.
- Serum T-kininogen levels and anastomotic hydroxyproline content were analyzed as markers for inflammation and collagen deposition, respectively.
Main Results:
- Octreotide, even at high doses, did not adversely affect anastomotic bursting strength, systemic inflammation, or collagen content in rats.
- Hydrocortisone, used as a negative control, significantly impaired bursting strength and reduced systemic inflammation, as anticipated.
- The findings indicate no deleterious effects of octreotide on key parameters of intestinal healing.
Conclusions:
- Octreotide does not appear to negatively impact small bowel anastomotic healing in a rat model.
- These results suggest that octreotide can be safely administered to patients with recent bowel anastomoses.
- Clinical use of octreotide may not jeopardize intestinal anastomosis integrity, offering significant clinical implications.