Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
5-Year IF – 2.0, IF – 1.9, JCI (2024) – 0.43
Scopus CiteScore – 4.3
Q1 in SJR 2024, SJR score – 0.598, H-index: 49 (SJR)
ICV – 161.00; MNiSW – 70 pts
Initial editorial assessment and first decision within 24 h

ISSN 1899–5276 (print), ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 12, December, p. 1683–1689

doi: 10.17219/acem/110329

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Effects of ozone preconditioning on recovery of rat colon anastomosis after preoperative radiotherapy

İlhan Taşdöven1,A,B,C,D,E,F, Ali Uğur Emre2,B,C,E, Fatma Ayça Gültekin2,A,B,C, Muzaffer Önder Öner3,B,C, Bekir Hakan Bakkal4,B,C, Ümmühani Özel Türkcü5,C,E,F, Banu Doğan Gün6,C, Gülin Ergun Taşdöven6,D,E,F

1 Department of General Surgery, Van Training and Research Hospital, Turkey

2 Department of General Surgery, Bülent Ecevit University, Zonguldak, Turkey

3 Department of Radiation Oncology, Bülent Ecevit University, Zonguldak, Turkey

4 Department of Medical Biochemistry, Faculty of Medicine, Muğla Sıtkı Koçman University, Turkey

5 Department of Pathology, Bülent Ecevit University, Zonguldak, Turkey

6 Department of Otolaryngology, Van Training and Research Hospital, Turkey

Abstract

Background. Anastomotic leakage is a devastating complication of colorectal surgery. Neoadjuvant radiotherapy for colorectal cancer can affect the mechanical and biochemical parameters of anastomotic healing. It has been reported that ozone increases antioxidant enzyme activity and stimulates adaptive processes to oppose the pathophysiologic conditions mediated by reactive oxygen species (ROS).
Objectives. The objective of this study was to investigate the effect of controlled administration of ozone on the healing of anastomosis and the activation of antioxidant enzymes in the colon after radiotherapy.
Material and Methods. Rats (n = 48) were randomly assigned to the following groups: control groups (1 and 2), saline-treated and irradiated (IR) groups (3 and 4) and ozone oxidative preconditioning (OOP) and IR groups (5 and 6). Rats were exposed to whole-body IR (6 Gy) after pretreatment with either saline or ozone. Rats in groups 1, 3 and 5 were euthanized on postoperative day 3, whereas those in groups 2, 4 and 6 were euthanized on postoperative day 7. The anastomoses were performed on day 7 post-IR. The anastomotic segment was resected to measure hydroxyproline (HPO) content, myeloperoxidase (MPO) activity and malondialdehyde (MDA) concentration and for histopathological evaluation.
Results. The mean bursting pressure of the groups that underwent radiotherapy was lower than that of the control groups (p < 0.001). In groups 5 and 6, the tissue HPO concentrations were higher than those in groups 3 and 4. Although mean values for MPO activity in groups 5 and 6 were higher than those in groups 3 and 4, the differences were not significant. Regarding oxidative damage markers, MDA concentrations were significantly lower in group 5 than those in group 3.
Conclusion. In this experimental model, OOP exerted favorable effects on colon anastomotic healing after radiation exposure.

Key words

colon anastomosis, ozone oxidative preconditioning, radiotherapy, anastomotic leakage

References (27)

  1. Buchs NC, Gervaz P, Secic M, Bucher P, Mugnier-Konrad B, Morel P. Incidence, consequences, and risk factors for anastomotic dehiscence after colorectal surgery: A prospective monocentric study. Int J Colorectal Dis. 2008;23(3):265–270.
  2. Mettler FA, Jr, Voelz GL. Major radiation exposure: What to expect and how to respond. N Engl J Med. 2002;346(20):1554–1561.
  3. Coleman CN, Blakely WF, Fike JR, et al. Molecular and cellular biology of moderate-dose (1–10 Gy) radiation and potential mechanisms of radiation protection: Report of a workshop at Bethesda, Maryland, 17–18 December 2001. Radiat Res. 2003;159(6):812–834.
  4. Bocci V. Physical-chemical properties of ozone. Natural production of ozone. The toxicology of ozone. In: Bocci V, ed. Ozone. A New Medical Drug. Dordrecht, the Netherlands: Springer; 2005:5–8.
  5. Bocci V. How does ozone act? How and why can we avoid ozone toxicity? In: Bocci V, ed. Ozone. A New Medical Drug. Dordrecht, the Netherlands: Springer; 2005:19–28.
  6. Ajamieh HH, Menéndez S, Merino N, Martínez-Sánchez G, Re L, León O. Ischemic and ozone oxidative preconditioning in the protection against hepatic ischemic-reperfusion injury. Ozone Sci Eng. 2003;25(3):241–250.
  7. Barber E, Menéndez S, Leon OS, et al. Prevention of renal injury after induction of ozone tolerance in rats submitted to warm ischaemia. Mediators Inflamm. 1999;8(1):37–41.
  8. Berson EL, Remulla JF, Rosner B, Sandberg MA, Weigel-DiFranco C. Evaluation of patients with retinitis pigmentosa receiving electric stimulation, ozonated blood, and ocular surgery in Cuba. Arch Ophthalmol. 1996;114(5):560–563.
  9. Gultekin FA, Bakkal HB, Guven B, et al. Effects of ozone oxidative preconditioning on radiation-induced organ damage in rats. J Radiat Res. 2013;54(1):36–44.
  10. Jamall IS, Finelli UN, Que Hee SS. A simple method to determine nanogram levels of 4-hydroxyproline in biological tissues. Anal Biochem. 1981;112(1):70–75.
  11. Kivirikko KI, Laitinen O, Prockop DJ. Modifications of a specific assay for hydroxyproline in urine. Anal Biochem. 1967;19(2):249–255.
  12. Sun Y, Oberley LW, Li Y. A Simple method for clinical assay of superoxide dismutase. Clin Chem. 1988:34(13):497–500.
  13. Lowry OH, Rosebrough NJ, Farr AL, Randall RJ. Protein measurement with the folin phenol reagent. J Biol Chem. 1951;193(1):145–157.
  14. Houdart, R, Lavergne, A, Galian, A, Hautefeuille, P. Anatomo-pathological evolution of single-layer end-to-end intestinal anastomoses. A study of 210 colonic anastomoses in the rat, from the 2nd to 180th days [in French]. Gastroenterol Clin Biol. 1983;7(5):465–473.
  15. Kuzu MA, Kuzu J, Köksoy C, Aksoy FH, Uzal D. Histological evaluation of colonic anastomotic healing in the rat following preoperative 5-fluorouracil, fractionated irradiation and combined treatment. Int J Colorectal Dis. 1998;13(5–6):235–240.
  16. Phillips JD, Kim CS, Fonkalsrud EW, Zeng H, Dindar H. Effects of chronic corticosteroids and vitamin A on the healing of intestinal anastomoses. Am J Surg. 1992;163(1):71–77.
  17. Witte MB, Barbul A. Repair of full-thickness bowel injury. Cri Care Med. 2003; 31(8 Suppl):538–546.
  18. Cronin K, Jackson DS, Dunphy JE. Specific activity of hydroxyproline-tritium in the healing colon. Surg Gyn Obst. 1968;126(5):1061–1065.
  19. Ajamieh HH, Menéndez S, Martínez-Sánchez G, et al. Effects of ozone oxidative preconditioning on nitric oxide generation and cellular redox balance in a rat model of hepatic ischaemia reperfusion. Liver Int. 2004;24(1):55–62.
  20. Peralta C, Leon OS, Xaus C, et al. Protective effect of ozone treatment on the injury associated with hepatic ischemia reperfusion: Antioxidant-prooxidant balance. Free Radic Res. 1999;31(3):191–196.
  21. Re L, Mawsouf MN, Menendez S, Leon OS, Sanchez GM, Hernandez F. Ozone therapy: Clinical and basic evidence of it’s therapeutic potential. Arch Med Res. 2008;39(1):17–26.
  22. Leon OS, Menendez S, Merino N, et al. Ozone oxidative preconditioning: A protection against cellular damage by free radicals. Mediators Inflamm. 1998;7(4):289–294.
  23. Di Paolo N, Bocci V, Gaggiotti E. Ozone therapy. Int J Artif Organs. 2004;27(3):168–175.
  24. Stevens KR, Fletcher WS, Allen CV. Anterior resection and primary anastomosis following high dose preoperative irradiation for adenocarcinoma of the recto-sigmoid. Cancer. 1978;41(5):2065–2071.
  25. Pleskovic A, Zorc-Pleskovic R, Vraspir-Porenta O. Colon mucosal cells after combined radiotherapy and chemotherapy. Folia Biol (Praha). 2001;47(5):156–162.
  26. Blake DP, Bubrick MP, Kochsiek GG. Low anterior anastomotic dehiscence following preoperative irradiation with 6000 rads. Dis Colon Rectum. 1984;27(3):176.
  27. Winsey K, Simon RJ, Levenson S. Effect of supplemental vit-A on colon anastomotic healing in rats given preoperative irradiation. Am J Surg. 1987;153(2):153–156.
© Wroclaw Medical University