Fj. Savage et al., EFFECT OF COLONIC OBSTRUCTION ON THE DISTRIBUTION OF MATRIX METALLOPROTEINASES DURING ANASTOMOTIC HEALING, British Journal of Surgery, 85(1), 1998, pp. 72-75
Background Anastomotic dehiscence is common after surgery for colonic
obstruction. The strength of an anastomosis is dependent on collagen,
which is degraded by matrix metalloproteinases (MMPs). The aim of this
study was to determine the distribution of the MMPs and their inhibit
or, tissue inhibitor of metalloproteinases (TIMP) 1 in an experimental
model of colonic obstruction, with and without resection and anastomo
sis. Methods The distal colon of rabbits was obstructed with a Silasti
c ring for 24 h and then either the ring was removed or the obstructed
segment was resected and an anastomosis formed. Rabbits were killed i
mmediately or at intervals for up to 7 days after operation. The distr
ibution of the MMPs and TIMP-1 was examined by indirect immunofluoresc
ence. Results MMPs and TIMP-1 were present throughout the descending c
olon for 24 h in both groups. They persisted to the third day in rabbi
ts with an anastomosis but by day 7 were restricted to the suture line
. Their presence correlated with microscopic damage. Conclusion The ex
tensive distribution of the MMPs suggests that these enzymes contribut
e to anastomotic dehiscence, but only in the immediate postoperative p
eriod.