Ratlarda deneysel kolon anastomoz kaçağı modelindeintraperitoneal atorvastatin uygulamasının anastomozkaçağı onarımı üzerine etkisi
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Dosyalar
Tarih
2020
Yazarlar
Dergi Başlığı
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Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Anastomoz kaçağı cerrahide karşılaşılan en ciddi problemlerden biridir. Bu problemi çözmek için geçmişten günümüze pek çok çalışma yapılmış, fazla ilaç ve materyal denenmiş, fakat net bir sonuç elde edilememiştir. Amacımız anastomoz kaçağı onarımına intraperitoneal atorvastatin uygulamasının etkisini araştırmaktır. Yöntem: Çalışmamız 4 gruptan oluştu. Kontrol grubunda 8; primer onarım, atorvastatin ve DMSO gruplarında 10'ar rat yer aldı. Deneklerde çekumun hemen distalindeki kolon ansına transeksiyon uygulandı. Kontrol grubunda, transeksiyon sonrası kaçak oluşturmadan anastomoz yapıldı. Diğer gruplarda anastomozun antimezenterik tarafında 5 mm açıklık bırakıldı ve bu gruplara postoperatif birinci günde relaparotomi yapıldı. Primer onarım grubuna sadece primer onarım uygulandı. Atorvastatin grubuna primer onarımdan sonra 1 ml DMSO içerisinde çözündürülmüş 30 mg / kg atorvastatin intraperitoneal olarak uygulandı. DMSO grubunda primer onarımdan sonra 1 ml DMSO aynı şekilde uygulandı. Onarım yapılan gruplar postoperatif 5. günde; kontrol grubu ise diğer gruplarla aynı süre takip edilerek 6.günde sakrifiye edildi. Anastomoz patlama basınçları ölçüldü. Histopatolojik olarak fibroblast sayısı, inflamatuar hücre, anjiyogenez ve kollajen miktarı ölçüldü. Biyokimyasal olarak ise doku hidroksiprolin ve FGF-2 seviyeleri ölçüldü. Bulgular: Atorvastatin grubunda patlama basınçları oran olarak yüksekti fakat istatistiksel olarak gruplar arasında anlamlı fark yoktu. Primer onarım grubunda inflamatuar hücre atorvastatin grubuna göre anlamlı yüksek görüldü. Kontrol grubunda ise kollajen miktarı primer onarım ve DMSO gruplarına göre anlamlı yüksekti. Atorvastatin grubunda hidroksiprolin düzeyi diğer gruplara göre anlamlı yüksekti. FGF- 2 düzeyi ise atorvastatin grubunda primer onarım grubuna göre anlamlı yüksekti . Sonuç: Çalışmamız sonucunda intraperitoneal atorvastatin uygulamasının anastomoz üzerine olumlu etkisi olduğu görüldü. Yaptığımız çalışmanın bu konuda yapılacak diğer çalışmalara ışık tutacağını düşünüyoruz. Anahtar kelimeler: Anastomoz, anastomoz kaçağı,
Anastomotic leak is one of the most serious problems encountered in surgery. To solve this problem, many studies have been carried out from past to present, many drugs and materials have been tried, but a clear result has not been obtained. The aim of this study is to investigate the effect of intraperitoneal atorvastatin application on anastomotic leak repair. Method: Our study consisted of 4 groups. There were 8 rats in the control group; 10 rats in the primary repair, atorvastatin and DMSO groups. Transection was applied to the colon loop just distal to the caecum in the subjects. In the control group, re-anastomosis was performed after transection without causing any leakage. In other groups, an opening of 5 mm was left on the antimesenteric side of the anastomosis, and relaparotomy was performed in these groups on the first postoperative day. Only primary repair was applied to the primary repair group. After primary repair, 30 mg / kg atorvastatin dissolved in 1 ml DMSO was administered intraperitoneally to the atorvastatin group. In the DMSO group, 1 ml DMSO was applied in the same way after primary repair. The repaired groups were sacrificed on the 5th day after the repair. The control group was followed for the same time as the other groups, it was sacrificed on the 6th day without reoperation. Anastomotic bursting pressures were measured. Histopathological evaluation scored the number of fibroblasts, inflammatory cells, angiogenesis and collagen amount. In biochemical evaluation, tissue hydroxyproline and FGF-2 levels were measured. Results: Bursting pressures were proportionally higher in the atorvastatin group, but there was no statistically significant difference between the groups. Inflammatory cells in the primary repair group were significantly higher in the atorvastatin group. In vi the control group, the amount of collagen was significantly higher than the primary repair and DMSO groups. Hydroxyproline level was significantly higher in the atorvastatin group compared to the other groups. FGF-2 level was significantly higher in the atorvastatin group compared to the primary repair group. Conclusion: As a result of our study, we found that intraperitoneal atorvastatin administration has a positive effect on anastomosis. We think that our study will shed light on other studies on this subject.
Anastomotic leak is one of the most serious problems encountered in surgery. To solve this problem, many studies have been carried out from past to present, many drugs and materials have been tried, but a clear result has not been obtained. The aim of this study is to investigate the effect of intraperitoneal atorvastatin application on anastomotic leak repair. Method: Our study consisted of 4 groups. There were 8 rats in the control group; 10 rats in the primary repair, atorvastatin and DMSO groups. Transection was applied to the colon loop just distal to the caecum in the subjects. In the control group, re-anastomosis was performed after transection without causing any leakage. In other groups, an opening of 5 mm was left on the antimesenteric side of the anastomosis, and relaparotomy was performed in these groups on the first postoperative day. Only primary repair was applied to the primary repair group. After primary repair, 30 mg / kg atorvastatin dissolved in 1 ml DMSO was administered intraperitoneally to the atorvastatin group. In the DMSO group, 1 ml DMSO was applied in the same way after primary repair. The repaired groups were sacrificed on the 5th day after the repair. The control group was followed for the same time as the other groups, it was sacrificed on the 6th day without reoperation. Anastomotic bursting pressures were measured. Histopathological evaluation scored the number of fibroblasts, inflammatory cells, angiogenesis and collagen amount. In biochemical evaluation, tissue hydroxyproline and FGF-2 levels were measured. Results: Bursting pressures were proportionally higher in the atorvastatin group, but there was no statistically significant difference between the groups. Inflammatory cells in the primary repair group were significantly higher in the atorvastatin group. In vi the control group, the amount of collagen was significantly higher than the primary repair and DMSO groups. Hydroxyproline level was significantly higher in the atorvastatin group compared to the other groups. FGF-2 level was significantly higher in the atorvastatin group compared to the primary repair group. Conclusion: As a result of our study, we found that intraperitoneal atorvastatin administration has a positive effect on anastomosis. We think that our study will shed light on other studies on this subject.
Açıklama
Anahtar Kelimeler
Anastomoz, Anastomoz kaçağı, Atorvastatin, Anastomosis, Anastomotic leak, Atorvastatin
Kaynak
WoS Q Değeri
Scopus Q Değeri
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Künye
Kaşıkçı, Y. S. (2020). Ratlarda deneysel kolon anastomoz kaçağı modelindeintraperitoneal atorvastatin uygulamasının anastomozkaçağı onarımı üzerine etkisi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Genel Cerrahi Anabilim Dalı, Konya.
