Influence of Preoperative Feeding on the Healing of Colonic Anastomoses in Malnourished Rats

Gonçalves, Carolina Gomes MD
Groth, Anne Karoline MD
Ferreira, Marcelo MD
Matias, Jorge Eduardo F. MD, PhD
Coelho, Júlio Cezar U. MD, PhD
Campos, Antonio Carlos L. MD, PhD

Financial disclosure: none declared.

From the Department of Surgery, Hospital das Clinicas, Federal University of Paraná, Curitiba, PR, Brazil.

Received for publication April 18, 2007; accepted for publication June 12, 2008.

Address correspondence to: Carolina G. Gonçalves, MD, Department of Surgery, Federal University of Paraná, Angelo Sampaio 2692 Apt #63B, Curitiba, PR, Brazil, 80730–460; e-mail: [email protected].

Journal of Parenteral and Enteral Nutrition 33(1):p 83-89, January-February 2009. | DOI: 10.1177/0148607108327047

Background:

Malnutrition influences healing of gastrointestinal anastomoses. The authors hypothesize that colonic anastomotic healing is decreased by malnutrition and might be improved by preoperative feeding.

Methods:

Eighty adult male Wistar rats were divided into 4 groups: (1) control rats 1 (C1), fed regular chow ad libitum for 21 days; (2) malnourished pair-fed rats (M), fed 50% of the food ingested by the control rats for 21 days; (3) preoperative nutrition rats (PRE), fed 50% of the average of the controls for 21 days and then fed preoperative nutrition with regular chow ad libitum for 1 week before the operation; and (4) control rats 2 (C2), fed regular chow ad libitum for 28 days. On days 21 (C1 and M) and 28 (PRE and C2), rats underwent 2 colonic transections and, subsequently, 2 end-to-end anastomoses. Rats were killed on postoperative day 5. The anastomoses were ressected for tensile strength and histological analysis.

Results:

PRE rats showed increased maximal tensile strength vs the M group (0.09 ± 0.01 vs 0.15 ± 0.01; P < .05) and similar values of maximal tensile strength as the controls (0.15 ± 0.01 vs 0.15 ± 0.02; P = .91). Collagen type I was higher in controls vs the PRE group (6.13 ± 0.39 vs 4.90 ± 1.53; P < .05); nevertheless, the PRE group showed higher collagen type I than M rats (4.90 ± 0.36 vs 3.83 ± 0.35; P < .05).

Conclusions:

Preoperative feeding for 7 days increases the maximal tensile strength, as well as the percentage area of mature collagen, approaching similar values as the control group. (JPEN J Parenter Enteral Nutr. 2009;33:83–89)