Does hyperbaric oxygen therapy reduce the effects of ischemia on colonic anastomosis in laparoscopic colon resection?


COD: 01_2016_1208_2461 Categorie: ,

Seyfi Emir, Sibel Özkan Gürdal, Selim Sözen, Ilhan Bali, Ebru Yes¸ildag, Atilla Çelik, Savas¸ Güzel, Önder S¸ahin, Hakan Ay, Birol Topçu

Ann. Ital. Chir., 2016 87: 83-91

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BACKGROUND: An increase in intra-abdominal pressure causes a decrease in the splanchnic blood flow and the intramucosal
pH of the bowel, as well as increasing the risk of ischemia in the colon. The aim of the present study is to
evaluate the effect of hyperbaric oxygen therapy (HBOT) on the ischemia caused by laparoscopy in colonic anastomosis
in an experimental model of laparoscopic colonic surgery.
MATERIALS AND METHODS: We divided 30 male Wistar albino rats into three groups: Group A was the control (open colon
anastomosis); Group B received LCA (laparoscopic colon anastomosis); while Group C received both LCA and HBOT. Each
group contained ten animals. We placed Group C (LCA and HBOT) in an experimental hyperbaric chamber into which
we administered pure oxygen at 2.1 atmospheres absolute 100% oxygen for 60 min for ten consecutive days.
RESULTS: The anastomotic bursting pressure value was found to be higher in the open surgery group (226 ± 8.8) (Group
A). The result for Group C (213 ± 27), which received HBOT, was better than that for Group B (197 ± 27). However,
there was no statistically significant difference between Group B and Group C. Group A showed better healing than the
other groups, while significant differences in the fibroblast proliferation scores were found between Groups A and B. In
terms of tissue hydroxyproline levels, a significant difference was found between Groups A and B and between Groups
A and C, but not between Groups B and C.
CONCLUSIONS: HBOT increases the oxygen level in the injured tissue. Although HBOT might offer several advantages, it
had only a limited effect on the healing of colonic anastomosis in rats with increased intra-abdominal pressure in our study.