Περίληψη:
Background Current evidence regarding the effects of selective cyclooxygenase inhibitors on gastrointestinal anastomoses is controversial. An experimental randomized control study was conducted in our institution to histopathologically evaluate the consequences of parecoxib, on intestinal and abdominal wound healing. Methods Twenty-four adult Wistar rats underwent laparotomy, ascending colon transection, and hand-sewn anastomosis. They were randomized to receive either parecoxib (0.5 mg/kg twice daily) or 0.9% normal saline by intraperitoneal injection postoperatively. Animals were euthanatized either on the third or the seventh postoperative day. Semiquantitative methods were used to evaluate both intestinal and abdominal wounds for inflammatory cell composition, angiogenesis, fibroblasts, granular tissue, collagen deposition, epithelization, and presence of necrosis, exudate, and abscess formation. Results are presented as (parecoxib: median [IQR] versus control: median [IQR], P-value). Results No macroscopic anastomotic leakage or wound dehiscence was observed. Intestinal anastomoses in the parecoxib group, showed significantly decreased epithelization (2 [1] versus 3 [1], [P = 0.004]) and collagen deposition (2 [0] versus 3 [1], [P = 0.041]). No difference was observed in angiogenesis (3 [1] versus 2.5 [1], [P = 0.158]). Abdominal wall specimens appeared to demonstrate decreased epithelization (2 [2] versus 4 [0.5], [P = 0.0004]) in the treatment group. No difference between the two groups was identified regarding collagen deposition (2.5 [1] versus 2 [0.5], [P = 0.280]) and angiogenesis (2.5 [1] versus 2 [1], [P = 0.633]). Necrosis was significantly more present in the parecoxib group in both specimen types, (3.5 [1] versus 2.5 [1], [P = 0.017]) and (3 [1] versus 1 [0.5], [P < 0.0001]). Conclusions The present study shows that despite the absence of clinical adverse effects, parecoxib can impair anastomotic and abdominal wound healing on a histopathological level. © 2017 Elsevier Inc.
Συγγραφείς:
Martinou, E.
Drakopoulou, S.
Aravidou, E.
Sergentanis, T.
Kondi-Pafiti, A.
Argyra, E.
Voros, D.
Fragulidis, G.P.
Λέξεις-κλειδιά:
collagen; parecoxib; sodium chloride; collagen; cyclooxygenase 2 inhibitor; isoxazole derivative; parecoxib, abdominal injury; abdominal wall; abscess; adult; anastomosis; anastomosis leakage; angiogenesis; animal cell; animal experiment; animal tissue; Article; ascending colon; controlled study; drug efficacy; epithelization; exudate; fibroblast; gastrectomy; hand sewn anastomosis; in vitro study; in vivo study; inflammatory cell; intestine injury; laparotomy; male; nonhuman; postoperative period; priority journal; quantitative analysis; rat; surgical wound; tissue necrosis; wound healing; abdominal injury; anastomosis leakage; animal; chemically induced; drug effect; metabolism; pathophysiology; randomization; Wistar rat; wound healing, Abdominal Injuries; Anastomotic Leak; Animals; Collagen; Cyclooxygenase 2 Inhibitors; Isoxazoles; Male; Random Allocation; Rats; Rats, Wistar; Wound Healing
