Date Published: July 08, 2020
Publisher: Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia
Author(s): Ufuk Demir, Mustafa Edremitlioğlu, Emel Kandaş, Müşerref Hilal Şehitoğlu, Nihal Kılınç.
To examine the effects of quercetin on healing of experimental colon anastomosis injury in early and late period.
Eighty male Wistar-Albino rats were divided into 8 groups. For all groups, left colons of the rats were resected and for the rest end-to-end anastomosis was performed. Two of the groups for which the experiment protocol was ended on the 3rd and 7th day following the anastomosis were not administered with either quercetin or dimethylsulfoxide DMSO, whereas two other groups were administered with DMSO only, and four other groups were administered with quercetin dissolved in DMSO in doses of 20 and 100 mg/kg during the protocol. At the end of the study, anastomosis line was resected, histopathological evaluation was performed and bursting pressure, malondialdehyde, superoxide dismutase, catalase, and hydroxyproline levels were measured.
Quercetin significantly increased hydroxyproline, superoxide dismutase, catalase levels, histopathological healing score, bursting pressure values and decreased malondialdehyde level in early period. It also significantly increased superoxide dismutase, catalase, and hydroxyproline levels and decreased malondialdehyde level in late period.
It was seen that quercetin speeds up the injury healing process and reveals an antioxidant effect, specifically in early period.
Colon cancer is ranked third among all types of cancers as regards to incidence, whereas it is the second leading cause of cancer-related deaths1. Surgical intervention has an important role in treatment methods. Colorectal surgery is being widely used in colorectal cancers as well as ischemic colitis, ulcerative colitis, Crohn disease, mechanical intestinal obstruction, trauma, and recurrent diverticulitis2. Today, despite the developments in surgical techniques and the application of new technologies such as robotic surgery, there are still cases which end up with death after colon anastomosis when the anastomosis area cannot heal completely and there is a leakage3,4. Ischemia, anemia, malnutrition, tension in anastomotic line, surgical technique, localized infection, and obstruction in distal anastomosis may be listed among the possible causes of anastomotic leaks3,5. Whatever the cause, anastomotic leaks can still be observed at a rate of 1-19.2% after colorectal surgery interventions despite the developments in surgical techniques3,4,6.
No leakages were observed at the anastomosis area when abdomens of the rats were opened to take tissue samples after the anastomosis.
These are the key results of our study: Quercetin is one of the factors that have a significantly curative effect on injury healing in the early period; it increases antioxidant capacity both in the early and late period and contributes to injury healing.
The intraperitoneal application of quercetin dissolved in DMSO improves healing and reduces levels of tissue oxidative stress in colorectal anastomoses performed in rats. It is seen that quercetin contributes to healing of anastomosis injuries in the early period. It also regulates the oxidant and antioxidant parameters both in the early and the late period. According to these results, it can be suggested that quercetin accelerates the injury healing by improving antioxidant capacity.