EFFECT OF CHRONIC PERIOPERATIVE STEROIDS AND IMURAN ON COLONIC ANASTOMOTIC HEALING AND BURSTING STRENGTH IN A RAT MODEL

Abstract

The aim of present study was to compare the effects of long term chronic preoperative steroids and ozathioprine on colonic anastomotic healing and tissue strength. One hundred male Sprogue-Dawley rots weighting 260-330 grams were divided into four groups, each of which had 25 animals. Group I received two placebo tablets. Group II received a time release drug pellet(200 mg cortisone acetate in a 60 day release form) and a placebo pellet placed in the subcutaneous tissue of the posterior neck for an average dally dose of 3.3 mg cortisone. Group III received a time release drug pellet (50 mg azathioprine in a 60 day release form) and a placebo pellet for an average dally dose of 0.83 mg azathioprine. Group IV received two time release drug pellets(200 mg cortisone acetate and 50 mg azathioprine each in a 60 day release form). After 6 weeks all animals underwent division and anastomosis of their midtransverse colon. One and two weeks after the anastomosis, colonic bursting pressures were determined at the anastomotic site and in the normal left colon by measuring Intraluminal pressures at which leakage/rupture occurred. Blood cortisol levels and histopathologic changes were also compared. There was no significant difference in bursting pressures (anastomosis and normal left colon) between treated and control animals at 7 and 14 days. Bursting pressure at the anastomotic site was significantly lower then left colonic site at 7 and 14 days (p<0.05). The increase in pressure at the anastomotic site by 14 days was statistically significant for each group (p<0.05). There was no significant difference at left colon for first and second week. in conclusion, bursting pressure of the colonic anastomosis was not affected by long term administration of cortisone acetate and azathioprine at seventh and 14th days of anastomosis in this rat model.