Effects of levosimendan on anastomotic healing in an ischemic colon anastomosis model

Safety of surgery in patients with colorectal cancer and inflammatory bowel disease have gotten better significantly in recent years, because of improvvement in preoperative preparation, antibiotic prophylaxis, surgical technique and postoperative management. However, the complications include bleeding, anastomosis separation and leakage from the anastomosis area, stenosis and fistulas continue with a decrease. Ischemia of anastomosed intestinal segments are one of the most serious risk factor for anastomosis leakage. Colon is known that the most suitable organ for ischemia in the alimentary tract. Considering all these cases, leakages can be seen in colonic anastomoses which is with a wide range of applications and the management of this situation is not only cause serious morbidity for the patient, but it is also quite costly and laborious. It is known that, the effects of vasoactive agents on the splanknic perfusion have an importance. Levosimendan is a new agent with both inotropic and vasodilator properties, and various mechanisms provide vasodilatation. So these effects of Levosimendan on the healing of colon anostomosis is aim of our study. In or study, 60 rats randomized to 6 groups. In all of the experimental animals, left colon ischemic anastomosis performed on 4 cm ischemic segment by cutting of the mesocolon 2 cm distal and 2 cm proximal from transsection area. In group 1 rats, ishchemic colon anastomosis performed and reoperated at the 4th day of postoperative to take samples and measurements and then sacrificed. In group 2, same procedure performed except measurement and taking samples at the 7th day. In group 3 rats, 0,3 mg/kg/day (low dose) Levosimendan applied intraperitoneal and the same procedure applied like group 1. In group 4 rats, 0,3 mg/kg/day (low dose) Levosimendan applied intraperitoneal and the same procedure applied like group 2. In group 5 rats, 1 mg/kg/day (high dose) Levosimendan applied intraperitoneal and the same procedure applied like group 1. In group 6 rats, 1 mg/kg/day (high dose) Levosimendan applied intraperitoneal and the same procedure applied like group 2. There were no statistically significant differences in terms of biochemical parameters, but statistically significant differences were found in terms of bursting pressures and histopathological parameters. As a result, it was observed that Levosimendan ischemic colon anastomosis contributed positively to healing. Experimenting with larger groups and with more parameters will provide clearer and more reliable results in later times. Keywords: Ischemic colon anastomosis, anastomotic leakage, Levosimendan