The international surgical journal with global reach

This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Insulin‐like growth factor I improves aspects of mycophenolate mofetil‐impaired anastomotic healing in an experimental model. BJS 2008; 95: 793-798.

Published: 16th April 2008

Authors: R. A. Inglin, G. Baumann, O. J. Wagner, D. Candinas, B. Egger

Background

Patients taking immunosuppressants after transplantation may require intestinal surgery. Mycophenolate mofetil (MMF) has been found to impair the healing of colonic anastomoses in rats. This study examined whether insulin‐like growth factor (IGF) I prevents MMF impairment of anastomotic healing.

Method

Sixty‐three rats were divided into three groups (MMF, MMF/IGF and control). Animals underwent a sigmoid colon anastomosis with a 6/0 suture, and were killed on days 2, 4 and 6 after surgery. Investigations included bursting pressure measurement, morphometric analysis, and assessment of mucosal proliferation by 5‐bromo‐2′‐deoxyuridine and Ki67 immunohistochemistry of the anastomoses.

Results

The leak rate was three of 21, one of 20 and two of 20 in the MMF, MMF/IGF‐I and control groups respectively. Anastomotic bursting pressures were significantly lower in the MMF group than in the control group on days 2 and 4, but there was no significant difference by day 6. Values in the MMF/IGF‐I and control groups were similar. Colonic crypt depth was significantly reduced in MMF‐treated animals on days 2 and 4, but this impairment was attenuated by IGF‐I on day 4. Similarly, IGF‐I reduced the negative impact of MMF on mucosal proliferation on days 2 and 6.

Conclusion

Exogenous IGF‐I improves some aspects of MMF‐impaired anastomotic healing. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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