Evaluation of the effects of hyperbaric oxygen treatment and enoxaparin on left colon anastomosis. An experimental study.

Abstract

BACKGROUND: Surgical interventions on left colon lead to high morbidity. The problems in wound healing are the main cause of this morbidity. Hypoxia retards wound healing and hyperbaric oxygen treatment (HBOT) has an anti-hypoxic effect. MATERIALS AND METHODS: In this experimental study we divided eighty Wistar albino rats into eight groups and numbered between 1 and 8. Normal (non-ischemic) and ischemic left colon anastomosis were performed in the first and second four groups respectively. HBOT and subcutaneous enoxaparin were applied to the groups separately and in combination for four days, except the control groups. (Group-1 and Group-5). We measured anastomotic bursting pressures and performed pathological examinations besides electron microscopic study in one sample from each group after sacrificing the rats on the fourth day. RESULTS: There were no statistically significant differences in bursting pressures when we compared Group-1 with other non-ischemic groups, and Group-5 with Group-6, but there were statistically significant differences when we compared Group-5 with Group-7 and 8. In pathological examination, there were no statistically significant differences between the groups concerning necrosis, epithelization, granulation tissue formation and collagen deposition. Statistically significant differences were found in the scores of neovascularization when we compared Group-1 with Group-3 and 4, and Group-5 with Group-8. Electron microscopic evaluation revealed a prominent increase both in neovascularization and collagen fibers in the samples taken from the groups received enoxaparine and hyperbaric oxygen treatment in combination. CONCLUSIONS: These findings suggest that HBOT increases neovascularization and bursting pressures in ischemic colon anastomosis in contrast with enoxaparin.