INFLUENCE OF INTRAPERITONEAL 5-FLUOROURACIL PLUS FOLINIC ACID ON THE HEALING OF COLONIC ANASTOMOSES IN RATS

We studied the effects of intraperitoneal 5-fluorouracil (5-FU) admini stration with or without the addition of folinic acid (FA) on the heal ing of colonic anastomoses in rats immediately after surgery. Sixty-th ree male Wistar rats were subjected to colonic anastomosis. During sur gery, the rats were randomized into one of three groups. Therapy was a dministered as an intraoperative intraperitoneal injection which was r epeated once daily for the first 2, postoperative days. A 0.9% NaCl so lution was administered to the rats in the control group. In group 2, we injected 5-FU (20 mg/kg/day) and in group 3 5-FU (20 mg/kg/day) plu s FA (2 mg/kg/day). The rats were sacrificed on postoperative days 3, 5 or 8. Rupture of the anastomosis was significantly higher in the rat s of groups 2 and 3, compared with the control group (p < 0.05). There were, however, no differences between groups 2 and 3. Formation of ad hesions and abscesses was more common in groups 2 and 3 than in the co ntrol group for all study days. A significant difference in the anasto motic bursting pressure was measured for the control group in comparis on to groups 2 and 3 on days 5 and 8 (p < 0.05). Histologic evaluation also showed a more profound inflammatory reaction and delayed healing of the anastomoses in groups 2 and 3, compared to the control group. Therefore, the perioperative intraperitoneal administration of 5-FU ca n inhibit the healing of colonic anastomoses in rats. The addition of an intraperitoneal injection of FA does not aggravate this negative ef fect.