Arpit Jacob, Mathew (2007) Effect of Butyrate in the Healing of Colonic Anastomoses in Rats. Masters thesis, Christian Medical College, Vellore.
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Abstract
BACKGROUND: The body’s ability to replace injured or dead cells and repair tissues following inflammation is critical to survival. The repair of tissues involves two distinct processes – replacement of injured or dead cells by cells of the same type or regeneration and replacement by connective tissue called fibroplasia or fibrosis. Both these processes are determined by essentially similar mechanisms involving cell migration, proliferation and differentiation as well as cell-matrix interactions. The orderly regeneration of epithelial tissue requires a specialised extracellular matrix called the basement membrane which acts as a scaffolding. These processes are the basis of the complex phenomenon of wound healing. AIMS AND OBJECTIVES: 1. To assess the effect of intraluminal butyrate on the healing of anastomoses in rat colon by testing mechanical strength. 2. To compare the differences in the mechanical strength of ascending and descending colon with and without treatment with butyrate. 3. To assess the expression of Matrix Metalloproteinases in the healing colon and study the effect of butyrate on this expression. MATERIALS AND METHODS: Forty male albino rats of the Wistar strain weighing between 200 – 250 grams were used for the experiment. The animals were fed a fibre-free diet to minimise the production of SCFAs from the fibre in the colon. This was begun 2 days before the initial operation and continued till the end of the experiment. The diet used was a specially prepared purified fibre free diet based on the American Institute of Nutrition (AIN)-93M diet.105 The diet was prepared initially in a powder form and reconstituted every day with water to make a semi-solid diet. After 48 hours, the rats were anaesthetised using ether chamber and intra-peritoneal ketamine (50mg/kg) and a midline laparotomy was done. The colon was first washed out with normal saline and then transected in two places preserving the marginal vessels (Fig 6.1). The ascending colon was transected about 3 cms from the ileo-caecal junction and the descending colon about 3 cms from the peritoneal reflection. Specimens were taken from both areas, frozen immediately in liquid nitrogen and stored at -70°C. An end-to-end anastomosis was carried out with a single layer of interrupted 6. 0 proline sutures (Fig 6.2, 6.3). A diversion caecostomy was carried out and the abdomen closed in layers. Statistical Analysis: The results were tabulated on a spreadsheet and statistical analysis was done using SPSS software. RESULTS: Of the 40 rats used, 9 died during the course of the experiment. Six rats died during anaesthesia or in the immediate post-operative period. Of these, 4 animals died in the ether chamber possibly due to a reaction to ether or a vasovagal attack. One animal did not wake up after the operation and another animal died of acute cardiac tamponade as the post operative dose of saline was injected into the thorax instead of subcutaneously. Three animals died during the post operative period. One died on the first post-operative day possibly due to aspiration and two died on the fifth post-operative day due to intestinal obstruction. There were no demonstrable anastomotic leaks during the study. CONCLUSIONS: 1. Local instillation of butyrate significantly strengthens colonic anastomoses as measured by the bursting wall tension. 2. The effect of butyrate increases both the bursting pressure and the circumference of the anastomosis. 3. There is a difference in the strength of proximal and distal colonic anastomoses. 4. There was an increase in the expression of Matrix metalloproteinases in all the post operative specimens. There was no difference in the expression of MMP2, but an increase in the expression of MMP9 between the butyrate and saline arms.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Butyrate ; Healing ; Colonic Anastomoses ; Rats. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Devi S |
| Date Deposited: | 04 May 2018 02:04 |
| Last Modified: | 04 May 2018 02:04 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7416 |
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