The effect of the PAF receptor antagonist gingko biloba EGB 761 on local ischemia reperfusion injury of healing colonic anastomoses

Abstract

Purpose: To show the negative effects of intestinal ischemia and reperfusion over anastomic healing and to prevent the harmful effect of pathological mechanisms, caused by mediators, through treatment with Gingko Biloba EGB 761, a platelet activating factor (PAF) antagonist.

Material and Methods: 39 Wistar-Albino rats were divided into three groups of 13; sham, control (ischemia and reperfusion) and study (ischemia-reperfusion+EGB 761) groups. The rats in the sham group were subjected to descending colon transection and end-to-end anastomosis after a midline laparotomy. In the contol group rats (ischemia and reperfusion), an ischemia was created by clipping SMA with atraumatic clips, following midline laparotomy. Subsequently, anastomosis was done by descending colon transection, and reperfusion was restored at 30 minutes by removal of the clips. The rats in the study group received two equal parts of 60 mg/kg/day Gingko Biloba EGB 761 per oral b.i.d. starting three days before the operation, and ending on the 7th postoperative day. All rats were sacrificed on the 7th postoperative day and the colonic segments including the anastomotic area were resected and samplificated for measurements of bursting pressure and hydroxyproline levels.

Results: Anastomosis bursting pressures and hydroxyproline levels were found to be significantly lower in the control group (ischemia-reperfusion) compared to sham and study groups (ischemia-reperfusion+ Gingko Biloba EGB 761). No statistically significant difference was determined between sham and study groups in terms of these parameters.

Conclusion: The bursting pressure and hydroxyproline values in sham group are significantly decreased by ischemia-reperfusion and this decrement can be prevented by EGB 761.