The effect of Cilostazol on anastomotic healing in an experimental model of left colonic ischemia.

Metin Varlı "The effect of cilostazol on anastomotic healing in an experimental model of left colonic ischemia." Bülent Ecevit University Faculty of Medicine, General Surgery, Dissertation, Zonguldak 2014 Introduction and aim: There are resulted in rather with anastomosis related complications at gastrointestinal surgery. Until recently improved surgical, medical and technical progress, the high mortality and morbidity rates of anastomotic leakage researchers able to positively affect healing agents has led to work on. Ischemia is one of the most important factors affecting negatively on healing. Phosphodiesterase inhibitors are agents such as cyclic AMP and cyclic GMP prevent inactivation of an intracellular second Messenger and which was first discovered in rat brain. Cilostazol, a selective phosphodiesterase3 (PDE 3) inhibitor, is currently used in the treatment of peripheral vascular disease intermittent claudication. The main affect form is to increase blood flow by dilatation of arteries and to prevent coagulation by inhibiting platelet aggregation. From this point forth, we have created hypothesis that cilostazol, eliminates seen as the primary cause of the anastomotic leakage, in the negative effects of ischemia. The aim of our study, oral administration of cilostazol ischemia in the left colon anastomosis healing was to examine the effects. Materials and Methods: Thirty-two male Wistar albino rats were randomized to four groups of subjects each with 8 was created. Normal and ischemic left colon anastomosis was performed to subjects. Cilostazol was given to experimental group on 10 mg / kg / day with orogastric manner. 4 days after surgery anastomotic healing, bursting pressures, tissue hydroxyproline levels, histopathological and biochemical parameters were evaluated using analysis. Groups: Thirty-two rats were randomized into 4 groups. GROUP A: Standard anastomosis GROUP B: Standard anastomosis + cilostazol GROUP C: Ischemic anastomosis GROUP D: Ischemic anastomosis + cilostazol Results: Cilostazol administration, on day 4 was formed ischemia and was not formed ischemia environments, bursting pressures and tissue hydroxyproline levels were found to cause a statistically significant increase (p <0.05). Histopathological examination of ischemic anastomosis cilostazol in the group, inflammation and mucosal ischemia score was significantly lower (p <0.05). Cilostazol applied normal lumen group of patients, inflammation and neutrophil ratio significantly lower in ischemic anastomosis in group inflammation, neutrophil ratio, and mucosal ischemia score significantly lower (p <0.05). Applied cilostazol group, compared with the control group, significantly higher levels of super oxide dismutase, malondialdehyde, significantly lower than the amount found. Conclusion: Cilostazol in experimental models of ischemic colonic anastomosis application; bursting pressure, hydroxyproline levels, biochemical and histopathological to parameterize a positive effect has been shown to improve anastomotic healing. Dose-dependent changes can be examined, ischemia for suppressing tissue protective mechanism of action can be established and neovascularization, inflammation, metabolism of collagen and healing potent cells formed on the positive effect that causes the cellular event to clarify further studies are needed. Keywords: Colon Anastomosis, Cilostazol, Hydroxyproline