Ulus Travma Acil Cerrahi Derg. 2010; 16(6): 487-490

Sýçanlarda iskemik kolon anastomozu üzerine amelogenin (bir ekstraselüler matriks proteini) uygulamasý

Adem Karatas¹, Ahmet Kocael¹, Erman Aytac¹, Fahri Gokcal¹, Ziya Salihoglu², Hafize Uzun³, Melih Paksoy^1
1Ýstanbul Üniversitesi, Cerrahpaþa Týp Fakültesi, Genel Cerrahi Anabilim Dalý, Ýstanbul.
²Ýstanbul Üniversitesi, Cerrahpaþa Týp Fakültesi, Anesteziyoloji Anabilim Dalý, Ýstanbul.
³Ýstanbul Üniversitesi, Cerrahpaþa Týp Fakültesi, Biyokimya Anabilim Dalý, Ýstanbul.

AMAÇ
Ýskemi, baðýrsak kaynaklý acillere neden olan ve tedavilerini güçleþtiren belalý bir sorundur. Riskli kolon anastomozlarýnýn iyileþme sürecine olumlu katkýlarý olan bir yöntem veya ajan bulmak cerrahi araþtýrma alanýnda popüler bir konudur. Bir ekstraselüler matriks proteini olan amelogeninin gastrointestinal anastomozlarýn iyileþme sürecindeki rolü ile ilgili bilgi bulunmamaktadýr. Bu çalýþmada, amelogeninin iskemik kolon anastomozu üzerine etkileri deðerlendirilmiþtir.
GEREÇ VE YÖNTEM
Yetiþkin, erkek, 200-250 g aðýrlýðýnda Wistar Albino cinsi sýçanlar üç eþ gruba ayrýldý: normal kolon anastomozu grubu (n=8); iskemik kolon anastomozu grubu (n=8); amelogenin uygulanan iskemik kolon anastomozu grubu (n=8). Eþit ve yeterli miktarda amelogenin anastomoz hattýný tamamen örtecek þekilde topikal olarak uygulandý. Tüm sýçanlar ameliyat sonrasý dördüncü günde öldürüldü. Patlama basýncý ve perianastomotik kolon dokusu hidroksiprolin seviyesi ölçüldü.
BULGULAR
Ýskemik kolon anastomozu patlama basýncý, normal kolon anastomozu ve amelogenin uygulanan iskemik kolon anastomozu düzeyinden anlamlý olarak düþüktü (sýrasýyla p=0,006, p=0,008).
SONUÇ
Amelogenin uygulamasý iskemik kolon anastomozunun fiziksel saðlamlýðýný destekler.

Anahtar Kelimeler: Amelogenin, patlama basýncý; kolon anastomozu; iskemi.

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Amelogenin (an extracellular matrix protein) application on ischemic colon anastomosis in rats

Adem Karatas¹, Ahmet Kocael¹, Erman Aytac¹, Fahri Gokcal¹, Ziya Salihoglu², Hafize Uzun³, Melih Paksoy^1
1Department Of General Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
²Department Of Anesthesiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
³Department Of Biochemistry, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.

BACKGROUND
Ischemia is a troublesome problem that can cause intestinal emergencies and complicate the treatment. Identification of a chemical agent with beneficial effects on the healing process in risky colon anastomosis with the aim of reducing leakage rates is a popular topic in the era of surgical research. Data is lacking about the role of amelogenin, an extracellular matrix protein, during the healing process of gastrointestinal anastomosis. In this study, the effects of amelogenin treatment on ischemic colon anastomosis were evaluated.
METHODS
Adult male Wistar Albino rats weighing 200-250 g were divided into three weight-matched groups as normal colon anastomosis group (n=8), ischemic colon anastomosis group (n=8), and amelogenin-treated ischemic colon anastomosis group (n=8). Sufficient equal volume of amelogenin to cover the anastomosis area entirely was applied topically. All animals were sacrificed on postoperative day four. Bursting pressure levels were measured. Peri-anastomotic colon tissue hydroxyproline levels were also assessed.
RESULTS
Bursting pressure level of the ischemic colon anastomosis group was significantly lower than the normal colon anastomosis and the amelogenin-treated ischemic colon anastomosis groups, respectively (p=0.006, p=0.008).
CONCLUSION
Amelogenin treatment supports the physical strength of ischemic colon anastomosis.

Keywords: Amelogenin, bursting pressure; colon anastomosis; ischemia.

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ATIF KOPYALA