Effect of ischemia/reperfusion as a systemic phenomenon on anastomotic healing in the left colon

Intestinal ischemia/reperfusion provokes a local inflammatory response lead ing to a systemic inflammatory state, In this study we aimed to assess the effects of intestinal ischemia/reperfusion injury on anastomotic healing in the left colon with an intact vascular supply, A total of 91 Wistar albino rats were divided into three groups: sham-operated control (group I, n = 2 5), 30 minutes of intestinal ischemia/reperfusion (group II, n = 40), and 7 -day allopurinol pretreatment and intestinal ischemia/reperfusion (group II I, n = 29), After the reperfusion experiment, a segmental left colon resect ion and anastomosis were done, On postoperative days 3 and 7 anastomotic bu rsting pressure, anastomotic and operative complications, and intraabdomina l adhesions were assessed. Mortality rates were 1/25, 16/40, and 4/29 for g roups I, II, and III, respectively (p = 0.001). There was no difference amo ng the groups for wound and anastomotic healing parameters evaluated by mac roscopic criteria. On postoperative day 7 the mean bursting pressures were 220.3 +/- 18.5, 162.0 +/- 21.0, and 213.9 +/- 24.7 for groups I, III and II , respectively (p = 0.000), Significantly dense adhesions were found in gro up II (p = 0.000). Allopurinol pretreatment prevented the effects of ischem ia/reperfusion on anastomotic healing of the left colon. Intestinal/ischemi a reperfusion causes impairment of anastomotic healing of the left colon. I n addition to remote organ effects, reperfusion injury may affect anastomot ic healing in the viscera with an intact vascular supply.