The effect of intraperitoneal paclitaxel administration on colonic anastomosis.

BACKGROUND/AIMS: The effect of intraperitoneal administration of chemotherapeutic agents on colonic anastomosis are still under investigation. In this study the effects of intraperitoneally administered paclitaxel on rat colonic anastomosis was investigated. METHODOLOGY: After colonic anastomosis, 3 mL of isotonic saline was administered intraperitoneally to rats in control group (Group 1, n = 20). The study group (Group 2, n = 20), paclitaxel 3 mg/kg diluted with isotonic saline was administered intraperitoneally after colonic anastomosis. Rats were sacrificed on 14th day and mean body weight, mean anastomosis bursting pressure and the histopathology of the anastomosis site of the two groups were compared. RESULTS: Mean body weight was approximately the same with the preoperative values at 14th day in both groups. Anastomosis bursting pressure in paclitaxel group (127 +/- 3 mm Hg) was found to be similar to control group (133 +/- 5 mm Hg) (P > 0.05). Mucosal layer formation in the anastomosis line was complete on the 14th day in both groups. CONCLUSIONS: As a result intraperitoneal paclitaxel administration was found to be safe as it did not reduce the anastomotic strength and not delay wound healing.

The use of polytetrafluoroethylene (Gore-Tex) grafts in reconstruction of the urinary bladder.

The safety and histopathologic effects of polytetrafluoroethylene (Gore-Tex) grafts in reconstruction of the urinary bladder were examined. Following partial excision of the bladder Gore-Tex was placed, and the rats were sacrificed at days 7, 14 and 30. Gore-Tex did not cause urine infection, and there was no peritonitis or sepsis in any of the rats. Inflammation around the Gore-Tex diminished after four weeks. Some mononuclear cells and exudate were observed on the inner surface of the Gore-Tex. There was no inflammation or fibrosis in the mucosa and muscular layers of the remaining bladder. In this study the Gore-Tex graft was found to be an infection resistant, urine impermeable material, with no adverse effects on the urinary bladder. Gore-Tex is suggested as a safe material for the reconstruction of the urinary bladder.

Comparison of the effects of various anticancer agents on intestinal anastomosis after intraperitoneal administration.

In this study, the effects of intraperitoneal 5-fluorouracil (5-FU), cisplatinum (Cis), adriamycin (Adr), and methotrexate (MTX) administration on rat intestinal anastomosis were compared. Cis and MTX led to significant weight loss in the first 5 days compared with the control group. Within 14 days all rats except the MTX group nearly reached their preoperative weight. No remarkable weight loss or systemic toxicity was observed among the 5-FU and Adr groups. The anastomosis bursting pressure (ABP) at 1 week was significantly lower than that of the control group (P < 0.01 and P < 0.005, respectively). On day 14 the anastomosis bursting pressure in the Cis group was similar to that of the control group but was significantly lower in the MTX group (P < 0.002). Histopathologically, MTX avoided the development of a mucosal layer at the anastomosis site and led to ulcer formation in some of the rats. The ABPs at 7 and 14 days were similar to those in the control group. Neither of the agents had any significant mechanical or histopathologic adverse effects on anastomosis. According to the results of our study, MTX impaired the healing of the anastomosis, and we thus conclude that the intraperitoneal administration of this agent is not safe. On the other hand, Cis showed a detrimental effect on the anastomosis, particularly in the early phase, but this effect disappeared in the late phase. Cis thus should not be administered in the early postoperative phase. As a result, 5-FU and Adr were found to be the safest agents as they did not delay wound healing and did not reduce the anastomotic strength.