Early Postoperative Oral Intake Accelerates Upper Gastrointestinal Anastomotic Healing in the Rat Model
Early Postoperative Oral Intake Accelerates Upper Gastrointestinal Anastomotic Healing in the Rat Model
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DOI：
10.1016/j.jss.2010.01.004
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发表时间：
2011-08-01
影响因子：
2.2
通讯作者：
Ohkohchi, Nobuhiro
中科院分区：
文献类型：
--
作者：
Tadano, Sosuke;Terashima, Hideo;Ohkohchi, Nobuhiro
背景在我们以前的研究中，我们报道了术后早期经口喂养加速大鼠上消化道吻合口愈合。为了研究其潜在的机制，我们进行了体内和体外实验。将接受近端空肠吻合的大鼠分为4组：肠内营养（EN）组通过胃造口喂养，完全胃肠外营养（TPN）组通过静脉导管喂养，TPN+生理盐水组通过胃造口额外给予生理盐水溶液，TPN+水组通过胃造口额外给予蒸馏水。术后5 d测定吻合口破裂压（ABP）和吻合口组织羟脯氨酸含量。在体外环境中，大鼠胃肠道成纤维细胞受到单轴拉伸60 min，并评估I型和III型胶原mRNA的表达。EN组、TPN+生理盐水组和TPN+水组的ABP和羟脯氨酸含量均显著高于单纯TPN组（ABP; 214.6 +/-42、199.4 +/-36和187.3 +/-29对149.5 +/-49 mmHg; P <0.01，羟脯氨酸; 63.5 +/-10、67.8 +/-13和64.1 +/-14对50.5 +/-12 μ mol/g干组织; P <0.01）。牵张刺激可增加I型和III型胶原mRNA的表达。这些结果表明，机械负荷在吻合口愈合中起着关键作用。需要进一步调查以证实这一建议。(C)2011 Elsevier Inc. All rights reserved.
Background. In our previous study, we reported that early postoperative oral feeding accelerated upper gastrointestinal anastomotic healing in rats. To investigate its underlying mechanism, we performed in vivo and in vitro experiments.Materials and Methods. Rats that received proximal jejunal anastomosis were divided into four groups: the enteral nutrition (EN) group were fed via gastrostomy, the total parental nutrition (TPN alone) group were fed via a venous catheter, the TPN + saline group received an additional administration of normal saline solution via gastrostomy, and the TPN + water group received an additional administration of distilled water via gastrostomy. The anastomotic bursting pressure (ABP) and the hydroxyproline content of the anastomotic tissue were measured 5 d postoperatively. In an in vitro setting, the rat gastrointestinal fibroblasts were subjected to uniaxial stretching for 60 min, and the expression of type I and type III collagen mRNA was evaluated.Results. The ABP and hydroxyproline content in the EN group, the TPN + saline group, and the TPN + water group were significantly higher than those in the TPN alone group (ABP; 214.6 +/- 42, 199.4 +/- 36, and 187.3 +/- 29 versus 149.5 +/- 49 mmHg; P < 0.01, hydroxyproline; 63.5 +/- 10, 67.8 +/- 13, and 64.1 +/- 14 versus 50.5 +/- 12 mu mol/g dry tissue; P < 0.01). The mRNA levels of type I and type III collagen were increased by stretch stimulation.Conclusions. These results suggest that mechanical loading plays a key role in anastomotic healing. Further investigations are necessary to confirm this suggestion. (C) 2011 Elsevier Inc. All rights reserved.