Effect of sodium carboxymethylcellulose and methylprednisolone on the healing of jejunal anastomoses in rats.

Sodium carboxymethylcellulose (SCMC) has been effective in reducing adhesion formation and corticosteroids reduce the inflammatory process. The objective of this study was to define the intraperitoneal (ip) effects of SCMC combined with intramuscular (im) methylprednisolone on peritoneal adhesion formation and on jejunal anastomosis healing in rats. Twenty Wistar rats (200-350 g) were divided into four groups (N = 5): groups I and III (controls) 5 and 21 days of treatment before sacrifice, respectively; groups II and IV (experimental groups) 5 and 21 days of treatment, respectively. SCMC (1%) was infused into the abdominal cavity and methylprednisolone (10 mg kg-1 day-1) was injected im daily from the day before surgery for animals of groups II and IV. All rats were submitted to a jejunal anastomosis. Sections of the anastomosis were prepared for routine histopathological analysis. The abdominal adhesion of group IV was less intense when compared with group III (P<0.0008). Anastomotic resistance was higher in groups II and IV when compared with groups I and III, respectively (P<0.05). There was no histological difference between groups I and II (exuberant granulation tissue on the serosal surface). Group III presented little peritoneal fibrinous tissue, with numerous thick collagen fibers. Group IV presented extensive although immature young fibrous tissue with rare thick collagen fibers. Sodium carboxymethylcellulose combined with corticosteroids seemed to diminish peritoneal adhesion but did not reduce anastomotic resistance.

Effect of sodium carboxymethylcellulose and methylprednisolone on the healing of jejunal anastomoses in rats

Sodium carboxymethylcellulose (SCMC) has been effective in reducing adhesion formation and corticosteroids reduce the inflammatory process. The objective of this study was to define the intraperitoneal (ip) effects of SCMC combined with intramuscular (im) methylprednisolone on peritoneal adhesion formation and on jejunal anastomosis healing in rats. Twenty Wistar rats (200-350 g) were divided into four groups (N = 5): groups I and III (controls) 5 and 21 days of treatment before sacrifice, respectively; groups II and IV (experimental groups) 5 and 21 days of treatment, respectively. SCMC (1 percent) was infused into the abdominal cavity and methylprednisolone (10 mg kg-1 day-1) was injected im daily from the day before surgery for animals of groups II and IV. All rats were submitted to a jejunal anastomosis. Sections of the anastomosis were prepared for routine histopathological analysis. The abdominal adhesion of group IV was less intense when compared with group III (P<0.0008). Anastomotic resistance was higher in groups II and IV when compared with groups I and III, respectively (P<0.05). There was no histological difference between groups I and II (exuberant granulation tissue on the serosal surface). Group III presented little peritoneal fibrinous tissue, with numerous thick collagen fibers. Group IV presented extensive although immature young fibrous tissue with rare thick collagen fibers. Sodium carboxymethylcellulose combined with corticosteroids seemed to diminish peritoneal adhesion but did not reduce anastomotic resistance

[Changes in the gastric mucosa after iso- and anisoperistaltic gastrojejunostomy in rats]. / Alterações da mucosa gástrica na gastrojejunostomia isoperistáltica e anisoperistáltica em rato.

Gastrojejunostomies are frequently associated to postoperative manifestations, provoked by biliopancreatic reflux to the stomach. Not only the symptoms can be severe, but also regenerative and reactional transformations of the gastric epithelium, dysplastic alterations and perianastomotic ulcers may be formed. Changes of gastric mucosa and their relation to surgical iso and anisoperistaltic gastrojejunal anastomosis were carried out. Gastrojejunostomies non associated with gastrectomy were performed in two groups (n = 7) of Holtzman rats. In the 30th postoperative day, the stomach and the jejunum close to the anastomosis were removed for pathohistological study. The group with anisoperistaltic anastomosis had a greater extension of histological alterations compatible with the histological picture of reflux gastropathy than the isoperistaltic group (P < 0.05). Three anastomotic ulcers were identified in the anisoperistaltic group and only one in the isoperistaltic, but these results were not statistically significant. Among the gastric surgeries, the gastrojejunostomies are the ones which cause greater biliopancreatic reflux. This reflux may induce changes in the gastric mucosa close to the anastomosis and even lead to cancer. According to other papers, the amount of reflux to the stomach can be directly related to the histological alterations on its mucosa. In conclusion, the anisoperistaltic gastrojejunostomy causes more changes in the gastric mucosa than the isoperistaltic, in this experimental model.