Influence of preoperative supplementation of omega-3 fatty acid in the healing of colonic anastomoses in malnourished rats receiving paclitaxel.

Alvo Orlando Vizzotto Junior,Tiago Jacometo Castilho,Eneri Vieira De Souza Leite Mello,Antonio Carlos Ligocki Campos

doi:10.1590/0100-69912015002009

Abstract

To evaluate the effect of preoperative supplementation of omega-3 fatty acids on the healing of colonic anastomoses in malnourished rats receiving paclitaxel. we studied 160 male Wistar rats, divided in two groups: one subjected to malnutrition by pair feeding (M) for four weeks, and another that received food ad libitum (W). In the fourth week, the groups were further divided into two subgroups that received omega-3 or olive oil by gavage. The animals were submitted to colonic transection and end-to-end anastomosis. After the operation, each of the four groups was divided into two subgroups that received intraperitoneal isovolumetric solutions of saline or paclitaxel. mortality was 26.8% higher in the group of animals that received paclitaxel (p = 0.003). The complete rupture strength was greater in well-nourished-oil Paclitaxel group (WOP) compared with the the malnourished-oil Paclitaxel one (MOP). The collagen maturation index was higher in well-nourished-oil saline group (WOS) in relation to the malnutrition-oil-saline group (MOS), lower in malnourished-oil-saline group (MOS) in relation to malnourished-ômega3-saline one (M3S) and lower in the well-nourished-omega3-saline group (W3S) compared with the malnourished-omega3-saline (M3S). The blood vessel count was higher in the malnourished-oil-saline group (MOS) than in the malnourished-oil-paclitaxel group (MOP) and lower in the malnourished-oil-saline group (MOS) in relation to the malnourished-omega3-paclitaxel group (M3P). supplementation with omega-3 fatty acids was associated with a significant increase in the production of mature collagen in malnourished animals, with a reversal of the harmful effects caused by malnutrition associated with the use of paclitaxel on the rupture strength, and with a stimulus to neoangiogenesis in the group receiving paclitaxel.

Highlights

Ovarian cancer is the second most common gynecological cancer in Brazil, with an annual mortality of about 15,000 cases[1]
The average blood vessels count (Figure 6) was significantly higher in the malnourished-ômega3-saline one (M3S) group compared with the malnourished-oil Paclitaxel one (MOP) group (12.64 ± 1.7 vs. 6.45 ± 0.28, p
The mortality rate was higher in the groups receiving paclitaxel compared with the groups that received saline, most due to anastomotic postoperative complications

Summary

Introduction

Ovarian cancer is the second most common gynecological cancer in Brazil, with an annual mortality of about 15,000 cases[1] It is often diagnosed at a stage when there is peritoneal dissemination, and has surgery as its initial treatment approach with the aim of ideal cytoreductive resection, i.e., residual disease that is less than 0.5cm[2]. To this end, intestinal segments resection and performance of colonic anastomosis are frequently required. The healing process of these colonic anastomosis takes place in an adverse environment, under the effects of malnutrition, which is very common in patients with ovarian cancer with peritoneal dissemination, and of the immunosuppressive effects of chemotherapy 4. Preoperative adequate renutrition is difficult in such patients, supplementation with specific nutritional elements in small volumes can be an alternative to accomplish it, especially if the substrate has a nutritional modulatory role in the healing process, enabling it to elapse with smaller effects of malnutrition[7]

Methods

Results

Conclusion