Abstract
PurposeHyperbaric oxygen treatment (HBOT) has been found to improve the healing of poorly oxygenated tissues. This study aimed to investigate the influence of HBOT on the healing in ischemic colorectal anastomosis.MethodsForty Wistar rats were randomly divided into a treatment group that received HBOT for 10 consecutive days (7 days before and 3 days after surgery), or in a control group, which did not receive the therapy. Colectomy with an ischemic anastomosis was performed in all rats. In each group, the rats were followed for 3 or 7 days after surgery to determine the influence of HBOT on anastomotic healing.ResultsFive rats from each group died during follow-up. No anastomotic dehiscence was seen in the HBOT group, compared to 37.5 % and 28.6 % dehiscence in the control group on postoperative day (POD) 3 and 7, respectively. The HBOT group had a significantly higher bursting pressure (130.9 ± 17.0 mmHg) than the control group (88.4 ± 46.7 mmHg; p = 0.03) on POD 3. On POD 3 and POD 7, the adhesion severity was significantly higher in the control groups than in the HBOT groups (p < 0.005). Kidney function (creatinine level) of the HBOT group was significantly better than of the control group on POD 7 (p = 0.001). Interestingly, a significantly higher number of CD206+ cells (marker for type 2 macrophages) was observed in the HBOT group at the anastomotic area on POD 3.ConclusionHyperbaric oxygen enhanced the healing of ischemic anastomoses in rats and improved the postoperative kidney function.Electronic supplementary materialThe online version of this article (doi:10.1007/s00384-016-2573-y) contains supplementary material, which is available to authorized users.
Highlights
Colorectal anastomotic leakage (CAL) is the most serious complication following colorectal surgery, causing substantial morbidity and mortality as high as 33 % [1]
In both the control groups and Hyperbaric oxygen treatment (HBOT) groups 5 animals died; all deaths are unrelated to anastomotic leakage: 5 colon ischemia, 4 colon ischemic necrosis, and 1 overdosed anesthesia
Significantly different between the HBOT group and control group at postoperative day (POD) 7 162.4 ± 39.7 mmHg vs. 141.1 ± 73.3 mmHg (p = 0.51), but the variance of anastomotic bursting pressure test (ABP) was significantly lower in the HBO group (p = 0.009)
Summary
Colorectal anastomotic leakage (CAL) is the most serious complication following colorectal surgery, causing substantial morbidity and mortality as high as 33 % [1]. Regional ischemia has been considered as one of the main causes of anastomotic leakage [5,6,7,8,9]. Poor blood supply and perfusion of the rectal stump and ascending loop of bowel, or prolonged hypoxia are detrimental for wound healing and increase the risk of CAL [5, 10, 11]. Bowel ischemia results in hypoxia of the cells. Prolonged severe ischemia causes necrosis of the mucosa layer, and lead to transmural infarction within 8 to 16 h [14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
