Effect of intraperitoneal cetuximab administration on colonic anastomosis and early postoperative adhesion formation in a rat model
Atilla Kurt1, Hasan Karanlık2, Sinan Soylu1, İlker Özgür2, Hilal Oğuz Soydinç3, Derya Duranyıldız3, Vakur Olgaç4, Fatma Şen5, Oktar Asoğlu6
1Department of General Surgery, Cumhuriyet University School of Medicine, Sivas, Turkey
2Institude of Oncology, Surgical Oncology Unit, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
3Department of Biochemistry, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
4Department of Pathology, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
5Department of Medical Oncology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
6Department of General Surgery, İstanbul Liv Hospital, İstanbul, Turkey
Objective: We aimed to evaluate the effect of intraperitoneal cetuximab administration on the healing of anastomosis and development of early adhesion formation in a rat model.
Materials and Methods: Twenty-four female rats were used. A colon segment was resected and end-to-end anastomosis was performed. The rats were randomized into three groups after the performance of colonic anastomosis and received 10 mL of intraperitoneal solution including study drugs after closure of abdominal cavity: normal saline was administered to the normal saline group (n=8), cetuximab (400 mg/m2) was administered to the postoperative 1 group (n=8) 1 day after surgery, and cetuximab (400 mg/m2) was administered to the peroperative group (n=8) during surgery.
Results: The mean adhesion grade was 2.63±0.92, and 0.50±0.76 and 0.63±0.74 for control and test groups, respectively. Cetuximab reduced adhesion formation in test groups (p<0.05). When all groups were compared, it was found that vascular endothelial growth factor levels decreased significantly only in the abdomen (p<0.05). Hydroxyproline levels and anastomosis bursting pressure were examined, and a statistical difference was found between groups (hydroxyproline p<0.05, bursting pressure p<0.05). However, when postoperative 1 day group was compared with the control group, it was found that there was no difference between groups according to these parameters (p>0.05), but when peroperative group was compared with the control group a significant decrease was observed in both parameters. Histopathological healing score was also evaluated. No statistical difference between groups was found.
Conclusion: Twenty-four hours later from the operation, intraperitoneal cetuximab therapy may be a safe and feasible treatment for metastatic colorectal patients.
Keywords: Intraperitoneal chemotherapy, cetuximab, anastomosis healing, adhesion formation
Ethics committee approval was received for this study from the ethics committee of İstanbul University Experimental Medicine Research Institute.
Concept – A.K., H.K.; Design – H.K., İ.Ö.; Supervision – O.A.; Resources – H.K., İ.Ö., H.O.S., D.D.; Materials – H.K., İ.Ö.; Data Collection and/or Processing – H.K., İ.Ö.; Analysis and/or Interpretation – A.K., S.S., F.Ş., V.O., H.O.S., D.D.; Literature Search – A.K., S.S.; Writing Manuscript – A.K.; Critical Review – H.K., S.S., O.A., F.Ş., H.O.S., İ.Ö.; Other – S.S.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.