Hasan Kesici1, Ali Naki Ulusoy1, Koray Topgül1, Hatice Paşaoğlu2, Nilüfer Bayraktar3, Gökhan Şenyürek1, Oktay Karaköse1

1Ondokuz Mayıs Üniversitesi Tıp Fakültesi Genel Cerrahi AD, SAMSUN
2 Gazi Üniversitesi Tıp Fakültesi Biyokimya AD, ANKARA
3 Başkent Üniversitesi, Ankara Hastanesi, Biyokimya Laboratuarı, ANKARA


Summary: The effect of taurolidine on healing of colonic anastomosis in rats with obstructive jaundice Purpose: The aim of the study is to investigate the effect of Taurolidine on intestinal anastomosis and wound healing in rats with obstructive jaundice.

Material and Methods: In this study 40 male Wistar-Albino rats were used. Rats were not given any food for 12 hours before the procedure and a blood sample was taken for TNF-α. Rats were divided into two groups, each containing 20 rats. The first group was sham group and the second group was obstructive jaundice group that is performed by ligation and division of choleduct. Four days later from the first surgical procedure we performed full thickness incision and anastomosis to the descending colon. Group 1 and 2 were also subdivided within themselves. We administered 200 mg/kg/day isotonic sodium (IS) via intraperitoneal route for the first half and Taurolidine to the second. Rats were sacrificed 7 days after the anostomosis. Anastomotic segments were resected and explosion pressure was measured. Samples were take from these segments for hydroxiproline and histological investigation. Blood samples were also taken for TNF-α and bilirubin.

Results: Mean anastomosis explosion pressure in obstructive jaundice-IS group, was statistically significantly lower than the obstructive jaundice-Taurolidine (OJ-T) group and the IS only group (p<0.01). However there was not a significant difference between OJ-T and non obstructive jaundice group in mean explosion pressure (p>0.05). Mean tissue hydroxyproline concentration at the anastomosis of OJ-IS group was significantly lower than OJ-T and only IS groups (p<0.001). Mean TNF-α concentration at the anastomosis healing of OJ-IS was significantly higher than OJ-T and non-obstructive only IS group (p<0.001). When TNF-α concentrations were compared, there was no statistically significant difference between the Taurolidine-Obstructive jaundice and Tauroludine-non-obstructive groups. There was also no significant difference between non-obstructive Taurolidine and IS given groups. At the histopatological investigation, it was discovered that there was less edema and infiltration of inflammatory cells in every layer in OJ-T group when compared to OJ-IS group. However, new collagen synthesis accompanying fibroblastic activity and neoangiogenesis was more prominent in OJ-T group.

Conclusion: Intraperitoneally administered Taurolidine decreases high TNF-α levels and colonic anostomosis explosion pressure and positively affects hydroxyproline concentrations.

Keywords: Taurolidine, obstructive jaundice, healing of colonic anastomosis