Antithrombin III prevents deleterious effects of remote ischemia-reperfusion injury on healing of colonic anastomoses

Background: Antithrombin III is known as the most important natural inhibitor of thrombin activity and has been shown to attenuate local harmful effects of ischemia-reperfusion injury in many organs. In recent animal studies, delaying effect of remote organ ischemia-reperfusion injury on healing of...

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Published inThe American journal of surgery Vol. 184; no. 2; pp. 160 - 165
Main Authors Tekin, Koray, Aytekin, Faruk O, Özden, Akın, Bilgihan, Ayşe, Erdem, Ergün, Sungurtekin, Ugur, Güney, Yıldız
Format Journal Article
LanguageEnglish
Published New York, NY Elsevier Inc 01.08.2002
Elsevier
Elsevier Limited
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Summary:Background: Antithrombin III is known as the most important natural inhibitor of thrombin activity and has been shown to attenuate local harmful effects of ischemia-reperfusion injury in many organs. In recent animal studies, delaying effect of remote organ ischemia-reperfusion injury on healing of intestinal anastomoses has been demonstrated. In this study, we investigated whether antithrombin III reduces deleterious systemic effects of ischemia-reperfusion injury on healing of colonic anastomoses in rats. Methods: Anastomosis of the left colon was performed in 24 rats that were divided into three groups: sham operated control (group I, n = 8), 30 minutes of intestinal ischemia-reperfusion by superior mesenteric artery occlusion (group II, n = 8), antithrombin III treated group (250 U/kg before and after the ischemia-reperfusion, group III, n = 8). On postoperative day 6, all animals were sacrificed, and bursting pressure and tissue hydroxyproline content of the anastomoses were assessed and compared. Results: On postoperative day 6 the mean bursting pressures were 149.6 ± 4.8, 69.8 ± 13.5, and 121.8 ± 8.7 mm Hg for groups I, II, and III, respectively ( P = 0.000). Mean tissue hydroxyproline concentration values were 389.5 ± 29.6, 263.1 ± 10.0, and 376.0 ± 33.8 μg/mg for groups I, II, III respectively ( P = 0.005). Conclusions: This study showed that, antithrombin III treatment significantly prevented the delaying effect of remote organ ischemia-reperfusion injury on anastomotic healing in the colon. Further clinical studies are needed to clarify whether antithrombin may be a useful therapeutic agent to increase the safety of the anastomosis during particular operations where remote organ ischemia-reperfusion injury takes place.
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ISSN:0002-9610
1879-1883
DOI:10.1016/S0002-9610(02)00908-X