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Immediate postoperative 5-FU does not decrease colonic anastomotic strength

G P Yazdi1, B W Miedema, L Humphrey

  • 1Department of Surgery, Harry S. Truman VA Hospital, University of Missouri-Ellis Fischel Cancer Center, Columbia, USA.

Journal of Surgical Oncology
|December 10, 1998
PubMed
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Postoperative continuous infusion of 5-Fluorouracil (5-FU) in rats did not alter colon anastomosis bursting strength, though it caused significant weight loss. This suggests 5-FU is safe for adjuvant therapy in colon cancer patients.

Area of Science:

  • Surgical Oncology
  • Gastrointestinal Surgery
  • Pharmacology

Background:

  • Adjuvant therapy for resected colon cancer may involve continuous infusion 5-Fluorouracil (5-FU).
  • A national phase III trial (Intergroup no. 0136) is investigating this treatment approach.
  • The impact of 5-FU on colon anastomosis integrity is crucial for patient safety.

Purpose of the Study:

  • To evaluate the effect of continuous infusion 5-FU on the bursting pressure of colon anastomoses in a rat model.
  • To assess the safety of immediate postoperative 5-FU administration in the context of colon cancer surgery.

Main Methods:

  • Lewis rats underwent sigmoid colectomy and single-layer anastomosis.
  • Ten rats received continuous 5-FU (600 mg/m2/day for 7 days); ten served as controls.

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  • Anastomotic bursting pressure was measured 10 days postoperatively.

    • Main Results:

    • No anastomotic leaks or intra-abdominal abscesses were observed in either group.
    • Colon bursting pressure was not significantly different between control (124+/-13 mm Hg) and 5-FU treated rats (115+/-9 mm Hg).
    • Rats receiving 5-FU experienced significant weight loss (-19+/-13 g) compared to controls (13+/-7 g).

    Conclusions:

    • Continuous infusion 5-FU postoperatively does not compromise colon anastomotic bursting strength in rats.
    • Postoperative 5-FU administration is associated with significant weight loss in this model.
    • Findings support the safety of continuous infusion 5-FU in the context of adjuvant therapy for resected colon cancer.