ABSTRACT

OBJECTIVE:

Bowel resection and anastomosis is required in a substential number of patients with inflammatory bowel disease either in emergent or elective setting during their lifespan. In this experimental study we aimed to investigate the role of low molecular weight heparin on anastomotic healing in rats with chemical induced inflammatory bowel disease.

Methods:

Seventy-two adult male Sprague Dowley(200 g-250 g) rats, divided in 5 groups; Group 1 (n=8): control, Group 2 (n=16): colitis, Group 3: (n=16) colitis + enoxaparine, Group 4: (n=16) colitis + anastomosis, Group 5: (n=16) colitis + enoxiparine + anastomosis. Colitis was induced by intrarectal installation of 2, 4, 6-trinitrobenzene sulphonic acid in 50% ethanol (TBNS). Enoxaparin 80ìg/kg was started intraperitoneally from 3rd day of colitis. At 2nd day of the treatment bowel divided and anastomosed at distal colon with experimental colitis. Each group subdivided in two as to those sacrificed on post operative day1 and 5. During sacrifications colonic resection incompasing anastomosis were performed. Specimens were assessed according to macroscopic and histologic tissue damage scale. Myeloperoxidase(MPO), Lipide Peroxisase (LP), Glutation (GSH) and Hydroxiprolin (HP) levels were also measured from colonic tissues.

Reults:

Enoxaparine therapy decreased the severity of macroscopic damage and the levels of MPO, increased the levels of GSH in all groups but no significant difference was observed for microscopic damage and of LP and HP levels. No undesirable effect of enoxiparine on the anastomotic healing was observed.

CONCLUSION:

Enoxaparine has no untoward effect on anostomic healing and it also seems to decrease inflamation and can safely be used during perioperative period. But these data indicate the need for a larger investigation.