Df. Silver et al., Recombinant growth hormone's effects on the strength and thickness of radiation-injured ileal anastomoses: A rat model, J SURG RES, 85(1), 1999, pp. 66-70
Background. Small bowel resections following radiotherapy for gynecologic c
ancers have resulted in significant rates of morbidity and mortality. The o
bjective of this study was to evaluate the effect of rGH on the breaking st
rength and thickness of radiation-injured ileal anastomoses in an animal mo
del.
Material and methods. Sprague-Dawley rats were treated with 1800 cGy of pel
vic irradiation in a single fractionation. Seventeen weeks following pelvic
teletherapy an ileo-ileostomy was performed. The rats were randomized to r
eceive 2.0 mg/kg/day of rGH for 7 days or placebo. On the seventh postopera
tive day a segment of ileum surrounding the anastomosis was resected. The s
egments were tested for breaking strength or were histologically measured f
or anastomotic thickness.
Results. The ileal anastomotic breaking strength in the rGH group was 181 /- 8.4 g (mean +/- standard error). The breaking strength of ileal anastomo
ses in the placebo group was 133 +/- 6.9 g (P < 0.05). The rGH group demons
trated a greater anastomotic thickness (1.65 +/- 0.116 mm) than the placebo
group (1.17 +/- 0.113 mm, P < 0.05). Of placebo rats 14.7% developed anast
omotic leaks compared to 0% of rGH-treated animals (P < 0.05).
Conclusions. RGH increased the ileal anastomotic breaking strength by 36% i
n radiated rats. The anastomotic leak rate was reduced from 14.7% in the pl
acebo group to 0% in the rGH group. These findings correlated with a 41% in
crease in the thickness of the anastomotic connective tissue in the rGH gro
up. Clinical investigation in selected patients is warranted. (C) 1999 Acad
emic Press.