ABSTRACT

This study was designed to assess the effect of intra-peritoneal Bosentan (endothelin antagonist) on healing process of left colonic anastomosis and intra-abdominal adhesion formation in rat with fecal peritonitis.

The study was conducted on 16 female Spraque-dowley rats. Left colonic punctures were performed 3 cm above the peritoneal reflection in rats, resection and primary anastomoses were carried out after 24 hours. Peritonitis were scored. Two rats died in this period. The remaining 14 rats were randomized in two groups of 7 each: Two milliliter of saline and Bosentan (30 mg/kg/day) for 6 days were given intraperitoneally in Group 1 and 2, respectively. On postoperativ day 6, intra-abdominal adhesions were scored. Healing of anastomosis, anastomotic bursting pressures, tissue hydroxyproline levels and histopatologically healing scores were assessed.

Peritonitis scores were similiar in both groups before the treatment. In Groups 2 compared to Group 1; peritonitis score, macroscopic adhesion score were lower, mean anastomotic bursting pressures were significantly higher(p<0.05), tissue hydroxyproline levels was not significantly different(p>0.05). Histopathological wound healing scores were significantly higher, neovascularization was significantly higher, the lymphocyte count and polymorphonuclear leukocyte (PMNL) counts were not significantly different.

Administration of Bosentan has a positive impact on left colonic anastomosis and of adhesion formation in peritonitis.