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Impact of remote ischemic preconditioning on wound healing in small bowel anastomoses

World Journal of Gastroenterology 2011年第10期17卷 1308-1316页

作者： philipp anton holzner Birte Kulemann Simon Kuesters Sylvia Timme Jens Hoeppner Ulrich Theodor Hopt Goran Marjanovic Surgical Metabolic and Anastomotic Research Team Department of General and Visceral SurgeryAlbert Ludwigs University of Freiburg Institute of Pathology Albert Ludwigs University of Freiburg

AIM： To investigate the influence of remote ischemic preconditioning （RIPC） on anastomotic integrity. METHODS： Sixty male Wistar rats were randomized to six groups. The control group （n = 10） had an end- to-end ileal anastomosis without RIPC. The preconditioned groups （n = 34） varied in time of ischemia and time of reperfusion. One group received the amino acid L-arginine before constructing the anastomosis （n = 9）. On postoperative day 4, the rats were re-laparotomized, and bursting pressure, hydroxyproline concentration, intra-abdominal adhesions, and a histological score concerning the mucosat ischemic injury were collected. The data are given as median （range）.RESULTS： On postoperative day 4, median bursting pressure was 124 mmHg （60-146 mmHg） in the control group. The experimental groups did not show a statistically significant difference （P 〉 0.05）. Regarding the hydroxyproline concentration, we did not find any significant variation in the experimental groups. We detected significantly less mucosal injury in the RIPC groups. Furthermore, we assessed more extensive intra-abdominal adhesions in the preconditioned groups than in the control group. CONCLUSION： RIPC directly before performing small bowel anastomosis does not affect anastomotic stability in the early period, as seen in ischemic preconditioning.

关键词： Anastomotic healing Hydroxyproline Bursting pressure Mucosal injury index Wound healing Remote ischemic preconditioning

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Comparison of hyperthermic intraperitoneal chemotherapy regimens for treatment of peritoneal-metastasized colorectal cancer

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World Journal of Gastrointestinal Oncology 2020年第8期12卷 903-917页

作者： Julia Spiegelberg Hannes Neeff philipp holzner Mira Runkel Stefan Fichtner-Feigl Torben Glatz Department of General and Visceral Surgery Medical Center–University of FreiburgFreiburg 79106Germany Department of Surgery Marien Hospital HerneRuhr-University BochumHerne 44625Germany

BACKGROUND Cytoreductive surgery(CRS)in combination with hyperthermic intraperitoneal chemotherapy(HIPEC)improves patient survival in colorectal cancer(CRC)with peritoneal carcinomatosis(PC).Commonly used cytotoxic agents include mitomycin C(MMC)and *** have reported varying results,and the evidence for the choice of the HIPEC agent and uniform procedure protocols is *** To evaluate therapeutic benefits and complications of CRS+MMC vs oxaliplatin HIPEC in patients with peritoneal metastasized CRC as well as prognostic *** One hundred and two consecutive patients who had undergone CRS and HIPEC for CRC PC between 2007 and 2019 at the Medical Center of the University Freiburg regarding interdisciplinary cancer conference decision were retrospectively *** and MMC were used in 68 and 34 patients,*** patient’s demographics and tumour characteristics,operative details,postoperative complications and survival were *** were stratified and graded using Clavien/Dindo *** outcome factors were identified using univariate and multivariate analysis of *** The two groups did not differ significantly regarding baseline *** found no difference in median overall survival between MMC and oxaliplatin *** postoperative complications,patients treated with oxaliplatin HIPEC suffered increased complications(66.2%vs 35.3%;P=0.003),particularly intestinal atony,intraabdominal infections and urinary tract infection,and had a prolonged intensive care unit stay compared to the MMC group(7.2 d vs 4.4 d;P=0.035).Regarding univariate analysis of survival,we found primary tumour factors,nodal positivity and resection margins to be of prognostic value as well as peritoneal cancer index(PCI)-score and the completeness of cytoreduction regarding peritoneal *** analysis of survival confirmed primary distant metastasis and primary tumour resec

关键词： Colorectal cancer Peritoneal carcinomatosis Cytoreductive surgery Hyperthermic intraperitoneal chemotherapy Chemotherapy Mitomycin

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