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Is platelet-rich plasma improves the anastomotic healing in hyperthermic intraperitoneal chemotherapy with oxaliplatin: an experimental rat study

Annals of Surgical Treatment and Research 2020년 98권 2호 p.89 ~ 95
 ( Buk Omer Faruk ) - Samsun Research and Training Hospital University of Healthy Sciences Department of General Surgery

 ( Ocak Sonmez ) - Samsun Research and Training Hospital University of Healthy Sciences Department of General Surgery
 ( Genc Bugra ) - Ondokuz Mayis University Faculty of Veterinary Medicine Department of Animal Nutrition and Nutritional Diseases
 ( Avci Bahattin ) - Ondokuz Mayis University Faculty of Medicine Department of Biochemistry
 ( Uzuner Hatice Olger ) - Samsun Research and Training Hospital University of Healthy Sciences Department of Pathology

Abstract


Purpose: Hyperthermic intraperitoneal chemotherapy (HIPEC) is a novel treatment option for peritoneal surface malignancies. Due to cytotoxic effects of chemotherapeutic agents, anastomosis healing can be impaired and lead to leakage rates higher than conventional intestinal surgery. In this experimental study, we aimed to investigate the effects of platelet-rich plasma (PRP) on colonic anastomosis in rats that received HIPEC with oxaliplatin.

Methods: Thirty rats were divided into 3 groups. Group 1 was determined as control group and hyperthermic saline perfusion was performed after colon anastomosis. In group 2, colon anastomosis then hyperthermic oxaliplatin perfusion was performed. In the last group, the colonic anastomosis was enhanced by PRP gel and then hyperthermic oxaliplatin perfusion was performed. All the rats were reoperated on postoperative day 7 and anastomotic bursting pressure values were recorded. Tissue samples were taken for hydroxyproline assay and histopathological examination.

Results: Control group had higher anastomotic bursting pressure value than group 2 and group 3 (P < 0.001). There were significant differences in anastomotic bursting pressure between groups 2 and 3 (P < 0.001). Group 2 had significantly lower hydroxyproline levels than group 3 and control group (P < 0.001). Histopathological examination revealed that PRP application reduced inflammatory response.

Conclusion: PRP application on colonic anastomosis improves anastomotic healing and can reduce anastomosis related complications and stoma creation; though further clinical studies are needed.

키워드

Anastomotic leak; Colonic neoplasms; Hyperthermia; Oxaliplatin; Platelet-rich plasma
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