Abstract
To investigate the effects of preoperative fractioned irradiation using an electron beam on the healing process of colocolonic anastomoses in rats that underwent early and late surgical intervention. Thirty Wistar rats, distributed as follows: group A (surgery only), group B (fractionated irradiation for 30 days (if), surgery seven days after the end of it), group C (if for 30 days, and surgery after 30 days of termination). On the seventh postoperative day the anastomotic segment analysis was taken, using tension tests, histology and collagen deposition evaluation by computerized analysis. Regarding the tension resistance of the anastomosis, there were no statistical differences (p=0.42). However, a significant increase in cells number in the inflammatory infiltrate in the group with a longer interval between surgery and pre op radiation (p<0.05). The collagen concentration had no significant variance. The irradiation in divided doses increased local inflammatory cellularity when the surgery was performed later. This result did not affect the increase of complications, nor on the local concentration of collagen, achieving similar clinical outcomes.
Highlights
Rectal neoplasia is a frequent infirmity, in which surgical treatment has presented up to 30% local recurrence
The beneficial role of neoadjuvant therapy has been well established in the literature, controversy exists regarding the best time for surgical intervention after preoperative fractioned irradiation
During evaluation of the bursting pressure of the colon wall, all animals were found to present the section on the line of the anastomosis
Summary
Rectal neoplasia is a frequent infirmity, in which surgical treatment has presented up to 30% local recurrence. With the use of neoadjuvant therapy, these values have been observed in more advanced stages of the neoplastic lesion, and the disease-free period is significantly longer[2]. Another advantage of preoperative radiotherapy is its capacity to sterilize tumor cells in perirectal fat, thereby decreasing locoregional reoccurrence[3]. In surgery to treat neoplasia performed 4-8 weeks after irradiation, lower toxicity and better capacity for tumor cytoreduction have been observed[4,5]
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