Efficacy of application of a human placenta hydrolysate in prophylaxis of the intestinal anastomoses sutures insufficiency
Objective. Studying of impact of a human placenta hydrolysate on regeneration of intestinal anastomosis and prophylaxis of their sutures insufficiency.
Materials and methods. Experimental investigations were conducted on two groups of rabbits. In every group a simulation model of an acute strangulation ileus was created. In a one day a relaparotomy, resection of necrotized intestinal segments with anastomosing in a “side-to-side” fashion were done in rabbits of both groups. After the operation the control group rabbits have obtained a standard treatment, while in the main group the rabbits together with a standard treatment have obtained a human placenta hydrolysate preparation «Laennec». On the days 3, 5, 7 and 15th the according intestinal segments were probed for morpho-histochemical investigations.
Clinical investigations were conducted in 122 patients, consisting of resection of intestinal segments with formation of anastomoses. The control group consisted of 60 patients, and the main one – in 62. The data of the control group were studied retrospectively. In the main group the patients, together with a standard treatment, a human placenta hydrolysate in a form of preparation “Laennec” was applied for prophylaxis of insufficiency of the intestinal anastomoses sutures.
Results. Basing on experimental results it may be stressed, that application of preparation «Laennec» strengthens regeneration and angiogenesis in zone of anastomosis, because in animals of the main group, comparing with a control one, high mitotic index, good angiogenesis and the motor-evacuation function integrity were noted.
In clinical practice the anastomotic sutures insufficiency in the control group have occurred in 13.3% of observations, and in the main group – in 1.6% of observations.
Conclusion. Application of the human placenta hydrolysate for prophylaxis of the sutures insufficiency in intestinal anastomoses is affordable due to successive clinical and experimental data obtained.
Lee SY, Kim CH, Kim HR. Anastomotic stricture after ultralow anterior or intersphincteric resection for very low lying rectal cancer. Journal Surgical Endoscopy. 2018;32(2):660-6. doi.org./10.1007/ s00464-017-5718-3.
Rybakov EG, Shelygin YA, Khomyakov EA, Zarodniuk IV. Risk factors for postoperative ileus after colorektal canser surgery. Colorectal Dis. 2018;20(3):189-94. doi: 10.1111/codi.13888.
Kingham T. Peter, Pachter H. Leon. Colonic Anastomotic Leak: Risk Factors, Diagnosis, and Treatment. J Am Coll Surg. 2009;208(2):269–78. doi: 10.1016/ j.jamcollsurg.2008.10.015.
Heisler KA. Treatment of Anastomotic Leak. J Am Coll Surg. 2014;219(3):592. doi:10.1016/ j.jamcollsurg.2014.06.004.
Phillips B. Reducing gastrointestinal anastomotic leak rates: review of challenges and solutions. Open Access Surgery. 2016;9:5-14. doi:10.2147/oas.s54936.
Fujita F, Torashima Y, Kuroki T, Eguchi S. The risk factors and predictive factors for anastomotic leakage after resection for colorectal cancer: reappraisal of the literature. Surg Today 2014;44(9):1595-1602. doi:10.1007/s00595-013-0685-3.
Nordentoft T, Pommergaard HC, Rosenberg J, Achiam MP. Fibrin glue does not improve healing of gastrointestinal anastomoses: a systematic review. Eur Surg Res. 2015;54(1-2):1-13. doi: 10.1159/000366418.
Wu Z, Boersema GS, Vakalopoulos KA, Daams F, Sparreboom CL. Critical analysis of cyanoacrylate in intestinal and colorectal anastomosis. J Biomed Mater Res B Appl Biomater. 2014;102(3):635-42. doi: 10.1002/jbm.b.33039.
Aghayev EK. Prevention of incompetence of sutures of intestinal anastomoses by the method of permanent intramesenteric blockade and lymphotrotropic therapy. Vestnik khirurgii. 2013;172(1):81-4. doi: 10.24884/0042-4625-2013-172-1-081-084.
Neutzling CB, Lustosa SA, Proenca IM, da Silva EM, Matos D. Stapled versus handsewn methods for colorectal anastomosis surgery. Cochrane Database Syst Rev. 201215;(2):1-8. doi: 10.1002/ 14651858.cd003144.pub2.
Placer C, Enríquez-Navascués JM, Elorza G, Timoteo A, Mugica JA, Borda N, et al. Preventing complications in colorectal anastomosis: results of a randomized controlled trial using bioabsorbable staple line reinforcement for circular stapler. Dis Colon Rectum. 2014;57(10):1195-201. doi: 10.1097/DCR.0000000000000207.
Sumer A, Altınlı E, Senger S, Koksal N, Onur E, Eroglu E, et al. Effect of pentoxifylline and vanpocetine on the healing of ischemic colon anastomosis: an experimental study. Ulusal Trauma Acil Cerrahi Dergisi. 2011;17(6):482-7. doi: 10.5505/tjtes.2011.75428.
Ding P, An X, Pan E. Meta-analysis of selective defunctioning stoma in low anterior resection. Ai Zheng. 2009;28(7):756-61. doi: 10.5732/cjc.008.10805.
Brisinda G, Vanella S, Cadeddu F, Mazzeo P. Colonic anastomotic leak: Risk factors, diagnosis and treatment. J Am Coll Surg. 2009;208(6):1152-3. doi: 10.1016/ j.jamcollsurg.2009.02.048.
Reisinger KW, Poeze M, Hulsewe KW, van Acker BA, van Bijnen AA, Hoofwijk AG, et al. Accurate prediction of anastomotic leakage after colorectal surgery using plasma markers for intestinal damage and inflammation. J Am Coll Surg. 2014;219(4):944-751. doi: 10.1016/j.jamcollsurg. 2014.06.011.
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