Ann Coloproctol.  2015 Dec;31(6):213-221. 10.3393/ac.2015.31.6.213.

Effects of a Glutamine Enema on Anastomotic Healing in an Animal Colon Anastomosis Model

Affiliations
  • 1Department of General Surgery, Esenler Maternity and Child Health Hospital, Istanbul, Turkey. manihabibi@gmail.com
  • 2Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey.
  • 3Department of General Surgery, Akdeniz University, School of Medicine, Antalya, Turkey.
  • 4Department of Biochemistry, Akdeniz University, School of Medicine, Antalya, Turkey.
  • 5Department of General Surgery, Karapinar State Hospital, Konya, Turkey.
  • 6Department of Pathology, Antalya Training and Research Hospital, Antalya, Turkey.

Abstract

PURPOSE
Anastomotic leakage in colorectal surgery is a very important issue. Although many studies have shown the positive effects of enteral glutamine (Gln) on anastomotic healing, none has assessed the effects of administering Gln via an enema for anastomotic healing. To fill this study gap, this study investigated the intraluminal effect of administration of Gln enema on the healing of colonic anastomosis in a rat model.
METHODS
Thirty Wistar albino rats were divided into three groups containing 10 rats each and were subjected to distal left colon transection and anastomosis. Postoperatively, group I (the control group) was administered no treatment, group II was administered daily placebo enemas containing physiological saline, and group III was administered daily 2% L-Gln enemas. After sacrifice on postoperative day 5, anastomotic healing, burst pressure, tissue hydroxyproline levels, and histological parameters were measured, and group values were compared via statistical analysis.
RESULTS
Group III was found to have the highest mean bursting pressure and tissue hydroxyproline levels and the lowest mean ischemia score. While the values of these parameters were not found to differ significantly among the groups, the lack of significance may have been due to the limited number of subjects examined.
CONCLUSION
Administration of a Gln enema may have a positive effect on anastomosis in terms of bursting pressure and histopathological parameters. Future research should examine administration of a preoperative Gln enema as a means of decreasing the traumatic effects of the enema and identifying its applicability in surgical practice.

Keyword

Surgical anastomosis; Anastomotic Leak; Enema; Glutamine; Hydroxyproline

MeSH Terms

Anastomosis, Surgical
Anastomotic Leak
Animals*
Colon*
Colorectal Surgery
Enema*
Glutamine*
Hydroxyproline
Ischemia
Models, Animal
Rats
Glutamine
Hydroxyproline
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