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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.
Background And Objectives:
The use of continuous infusion 5-Fluorouracil (5-FU) immediately after surgery may improve the adjuvant treatment of resected colon cancer and is the subject of a national phase III trial (Intergroup no. 0136). The aim was to determine the effect of continuous infusion 5-FU on the bursting pressure of a colon anastomosis.
Methods:
Twenty Lewis rats weighing approximately 300 g were subject to sigmoid colectomy and single-layer anastomosis. Ten rats received 5-FU continuously at 600 mg/m2 per day for 7 days; 10 rats served as controls. Ten days postoperatively, the rats were sacrificed and bursting pressure of the colon containing the anastomosis was determined.
Results:
No anastomotic leaks or intra-abdominal abscesses were identified. Burst pressure of the colon in controls (124+/-13 mm Hg; mean+/-SEM) was not significantly different from those animals receiving 5-FU (115+/-9, P > 0.05). The control rats gained weight (13+/-7 g), which is significantly different from the rats receiving 5-FU (-19+/-13, P=0.04).
Conclusions:
Continuous infusion 5-FU postoperatively results in weight loss, but does not affect anastomotic bursting strength in rats. This evidence supports the safety of continuous infusion 5-FU postoperatively in humans.