ORIGINAL ARTICLE

Effect of mechanical bowel preparation in fibroblast, collagen density and histopathology analysis in colon anastomosis site of Wistar rat

Dian Adi Syahputra , Dikki Drajat Kusmayadi, Bethy S Hernowo

Dian Adi Syahputra
Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Syiah Kuala University/Dr. Zainoel Abidin Hospital, Banda Aceh, Aceh, Indonesia. Email: [email protected]

Dikki Drajat Kusmayadi
Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Padjadjaran University/Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia

Bethy S Hernowo
Department of Pathology Anatomy, Faculty of Medicine, Padjadjaran University/Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia
Online First: February 02, 2020 | Cite this Article
Syahputra, D., Kusmayadi, D., Hernowo, B. 2020. Effect of mechanical bowel preparation in fibroblast, collagen density and histopathology analysis in colon anastomosis site of Wistar rat. Bali Medical Journal 9(1): 110-114. DOI:10.15562/bmj.v9i1.1699


Backgrounds: Mechanical bowel preparation (MBP) was almost considered dogmatic in colorectal surgery. There are several methods known to perform MBP. Anastomotic leakage is considered higher in patients who had MBP, and it is thought due to alteration colonic morphologic, electrolyte and fluid imbalance.

Methods: This is an experimental study divided into two groups.  This study aims to determine the difference in collagen density, amount of fibroblast and histopathologic features in the anastomotic site between Wistar rats that had MBP and without MBP to the colonic anastomosis. The first group consists of 6 Wistar rats who had colonic anastomosis without MBP, and the second group consists of 6 Wistar rats who had colonic anastomosis with BMP. On the 10th day after surgery, histopathology examination is performed with regards to collagen density, the number of fibroblasts, infiltration of inflammatory cells and the degree of bowel wall damage at the anastomotic site. Independent t-test is used to analyze the data if it is normally distributed and Mann-Whitney test is used if the data is not normally distributed.

Results: The amount of fibroblast was significant difference between two groups (p=0.02), which is amount of fibroblast in the second group (3.83 ± 0.408) is higher than the first group (2.33 ± 0.816). Meanwhile, there is no significant difference regarding collagen density, infiltration of inflammatory cells and the degree of bowel wall damage (p=0.59, p=0.082 dan p=1.00).

Conclusion: The conclusion of this research is by performing MBP prior to colonic anastomosis will exert the effect of more abundant fibroblast.

References

Balbaa MA, Sultan H, El-Sisy A, Abdel-Latif M, Zeid N. Non mechanical bowel preparation for elective life sided colorectal cancer surgery. Egyptian Journal of Surgery. 2010;18:18-22.

Pineda CE, Shelton AA, Boussard TH, Morton JM, Welton ML. Mechanical Bowel Preparation in Intestinal Surgery: A Meta-Analysis and Review of the Literature. J Gastrointest Surg. 2008;12(11):2037-2044.

Bucher P, Gervaz1 P, Soravia C, Mermillod B, Erne M, Morel P. Randomized clinical trial of mechanical bowel preparation versus no preparation before elective left-sided colorectal Surgery. British Journal of Surgery. 2005;92(4):409–414.

Jørgensen PW, Guenaga KF, Matos D, Castro AA. Pre-operative mechanical bowel cleansing or not? an updated meta-analysis. Colorectal Disease. 2005. 7(4):304–310.

Duncan JE, Quietmeyer CM. Bowel Preparation: Current Status. Clin Colon Rectal Surg, 2009;22(1):14–20.

Gravante G, Caruso R, Andreani SM, Giordano P. Mechanical bowel preparation for colorectal surgery: a meta-analysis on abdominal and systemic complications on almost 5,000 patients. Int J Colorectal Dis. 2008;23(12):1145–1150.

Bleday R, Braidt J, Ruoff K, Shellito PC, Ackroyd FW. Quantitative cultures of the mucosal-associated bacteria in the mechanically prepared colon and rectum. Dis Colon Rectum 1993;36(9):844–849.

Mahajna A, Krausz M, Rosin D, Shabtai M, Hershko D, Ayalon A, Zmora O. Bowel preparation is associated with spillage of bowel contents in colorectal surgery. Dis Colon Rectum. 2005;48(8):1626-31.

Bucher P, Gervaz P, Egger JF, Soravia C, Morel P. Morphologic alterations associated with mechanical bowel preparation before elective colorectal surgery: a randomized trial. Disease of the Colon and Rectum. 2006;49(1):109-12.

Kologlu MB, Senocak ME, Talim B, Kale G, Ocal T. A Comparative Histopathologic Evaluation of the Effects of Three Different Solutions Used for Whole Bowel Irrigation: An Experimental Study. Journal of Pediatric Surgery. 2000;35(4):564-568.

Thomas WEG, Reed MWR and Wyatt MG. Oxford Textbook of Fundamentals of Surgery. Oxford: Oxford University Press; 2016. p. 459-467.

Young HL, Wheeler MH. Collagenase inhibition in the healing colon. Journal of the Royal Society of Medicine. 1983;76(1):32-36.

Kosmidis C, Efthimiadis C, Anthimidis G, Basdanis G, Apostolidis S, Hytiroglou P, et al. Myofibroblasts and colonic anastomosis healing in Wistar rats. BMC Surgery. 2011;11:1-6.

Stumpf M, Krones CJ, Klinge U, Rosch R, Junge K, Schumpelick V. Collagen in colon disease. Hernia. 2006;22:498-501.

Mersin H, Bulut H, Berberoglu U. The effect of mechanical bowel preparation on colonic anastomosis healing: an experimental study. Acta Chir Belg. 2006;22:59-62.

Fa-Si-Oen PR, Penninckx F. The effect of mechanical bowel preparation on human colonic tissue in elective open colon surgery A microscopic comparative study. Disease Colon and Rectum. 2004;47:948-949.

Izuka M, Konno S. Wound healing of intestinal epithelial cells. World Journal of Gastroenterology. 2011;17(17):2161-2171.

Jung B, Lannerstad O, Påhlman L, Arodell M,Unosson M, Nilsson E. Preoperative mechanical preparation of the colon: the patient's Experience. BMC Surgery. 2007;1-5. https://doi.org/10.1186/1471-2482-7-5


No Supplementary Material available for this article.
Article Views      : 0
PDF Downloads : 0