Effect of platelet‐rich plasma on colon anastomosis in rats in which hyperthermic intra‐peritoneal chemotherapy was performed using 5‐fluorouracil

Effect of platelet‐rich plasma on colon anastomosis in rats in which hyperthermic intra‐peritoneal chemotherapy was performed using 5‐fluorouracil:

This experimental study aims to investigate the effect of platelet‐rich plasma gel on colon anastomosis in rats treated with hyperthermic intra‐peritoneal chemotherapy (HIPEC) using 5‐fluorouracil. The HIPEC procedure significantly reduces anastomotic bursting pressure through its negative effects on anastomotic healing. This paper suggests that the negative effect of HIPEC on anastomotic healing can be reversed by the application of platelet‐rich plasma gel.

Abstract

Background

Hyperthermic intra‐peritoneal chemotherapy (HIPEC) performed in patients with peritoneal carcinomatosis has a cytotoxic effect on tumour cells. This cytotoxic effect also adversely affects the wound healing of anastomosis, which is frequently undertaken in this patient group, and causes anastomotic leakage and intestinal fistulas. Platelet‐rich plasma (PRP) gel has been used in wound healing and has shown efficacy. We investigated the effect of PRP gel on colon anastomosis healing in rats treated with 5‐fluorouracil (5‐FU).

Methods

Twenty‐four rats were divided into three groups, each containing eight rats: group 1 (control) underwent colon anastomosis alone; group 2 (5‐FU) underwent a colon anastomosis and HIPEC; and group 3 (5‐FU + PRP) underwent a colon anastomosis and HIPEC and received topical PRP gel. The rats were sacrificed on the post‐operative day 7 and the anastomotic bursting pressure (ABP) was measured. Tissue samples were obtained to measure the hydroxyproline level and investigate the histopathological changes on the anastomosis line.

Results

ABP was higher in the control and 5‐FU + PRP groups than in the 5‐FU group (P = 0.009, P = 0.047). The tissue hydroxyproline levels were higher in the control and 5‐FU + PRP groups than in the 5‐FU group (P = 0.001, P = 0.030). The histopathological findings of the 5‐FU + PRP group were better than those of the 5‐FU group.

Conclusion

This study showed that the application of PRP gel to colon anastomoses increased ABP in rats treated with HIPEC using 5‐FU. It also showed positive effects on anastomotic healing by increasing the tissue hydroxyproline levels on the anastomosis line and reducing the inflammatory response.