THE EFFECT OF RECOMBINANT GROWTH-HORMONE ON THE STRENGTH OF ILEAL ANASTOMOSES IN A RAT MODEL

OBJECTIVE: In gynecologic surgery, the ileum is the primary site of bo wel injury. Recombinant growth hormone (rGH) has been shown to improve the strength of colonic anastomoses in experimental models. The purpo se of this study is to evaluate the effect of rGH on small bowel anast omoses, specifically in the ileum. METHODS: Twenty large female rats u nderwent segmental ileal resections and end-to-end ileoileostomies. Th e rats were randomized to be treated for 7 postoperative days with eit her rGH (2.0 mg/kg/day) or placebo starting on the day of surgery. On the seventh postoperative day, a segment of ileum surrounding the anas tomosis was resected. The anastomoses were tested for breaking strengt h on a tensiometer and for tissue concentrations of hydroxyproline. RE SULTS: The ileal anastomotic braking strength in the rGH group was 163 .5 +/- 6.0, g (mean +/- standard error). In the placebo group, the bre aking strength of ileal anastomoses was 125.0 +/- 3.0 g (P < .001). No significant difference was demonstrated with respect to the hydroxypr oline concentration between the rGH group (15.2 +/- 2.0 mu g/mg) and t he placebo group (14.6 +/- 1.0 mu g/mg). CONCLUSION: In an animal mode l, a 31% increase in ileal anastomotic breaking strength was induced b y rGH administration. With further research this may translate into de creases in the surgical complications that occur in ileal anastomoses. Furthermore, these serve as preliminary data to a study that evaluate s the effect of rGH on ileal anastomoses in radiation-injured bowel. C opyright (C) 1997 by the Society for Gynecologic Investigation.