Effect of ranitidine on healing of normal and transfusion-suppressed experimental anastomoses.

BACKGROUND: Histamine has been shown to participate in immune response. Wound healing is a process of immune system. This experimental study was done to find the effect of histamine2 receptor antagonist ranitidine on the healing process of intestinal anastomosis in rats. METHODS: Eighty Wistar rats in four groups of 20 each underwent colon resection and anastomosis. They were given 2 ml saline or blood, twice daily 0.4 ml saline or 0.4 ml saline containing 0.7 mg ranitidine. The animals were killed 3 or 7 days postoperatively and the anastomotic strength assessed by bursting pressure. RESULTS: The ranitidine group developed fewer anastomotic abscesses (p<0.001). Anastomotic strength was significantly reduced either on day 3 or 7 in animals given blood transfusions (p<0.04, p<0.001), whereas in animals given ranitidine this effect was partially reversed. CONCLUSIONS: These data indicate that ranitidine has no influence in anastomotic bursting pressure, but has a lower incidence of septic complications.

Prevention of blood-transfusion-induced impairment of anastomotic healing by leucocyte depletion in rats.

OBJECTIVE: To find out what effect whole blood and leucocyte-depleted blood transfusions had on the healing process of intestinal anastomoses in rats. DESIGN: Experimental study. SETTING: Teaching hospital, Greece. SUBJECTS: 100 Wistar rats in five groups of 20 each. INTERVENTIONS: Small and large bowel anastomoses were made and the five groups were given normal saline, homologous whole blood, heterologous whole blood obtained from PVG rats, homologous leucocyte-depleted blood or heterologous leucocytedepleted blood during the operation. MAIN OUTCOME MEASURES: Bursting pressures of anastomoses on the third and seventh postoperative days and infective complications. RESULTS: The groups given whole blood transfusions had significantly more anastomotic abscesses than controls (p = 0.003 compared with heterologous, p = 0.05 compared with homologous for the small bowel, and p = 0.007 for the large bowel). The pressure measurements indicated a significant reduction in anastomotic strength in the same groups compared with the control group (p = 0.0001/p = 0.001 on the third postoperative day, and p = 0.00001/p = 0.0004 on the seventh postoperative day for small and large bowel, respectively). There was no reduction in anastomotic strength in the leucocyte-depleted blood groups. CONCLUSIONS: Transfusion of leucocyte-depleted blood does not seem to impair intestinal anastomotic healing and carries an acceptable incidence of postoperative complications.