TY - JOUR
T1 - The effect of gender on early colonic anastomotic wound healing
AU - Kjaer, Marie
AU - Kristjánsdóttir, Hrefna
AU - Andersen, Line
AU - Heegaard, Anne Marie
AU - Ågren, Magnus S.
AU - Jorgensen, Lars N.
PY - 2018
Y1 - 2018
N2 - Purpose: Clinically, male patients subjected to colorectal surgery are more prone to develop anastomotic leakage than female patients by unknown mechanisms. Our aim was to investigate the impact of gender on anastomotic wound healing using an experimental model. Methods: One-layer colonic anastomosis was constructed in 8-week-old 28 male and 32 female Sprague-Dawley rats. Animals of one group (n = 30) were sacrificed immediately after surgery day 0 and the other group (n = 30) on postoperative day 3. Anastomotic breaking strength, total collagen (hydroxyproline), soluble collagen (Sircol), matrix metalloproteinase (MMP)-9, and transforming growth factor (TGF)-β1 were measured. Results: The anastomotic breaking strength decreased from day 0 to day 3 with no significant gender differences either in the extent of decline (P = 0.122) or absolute day 3 strengths (P = 0.425). Analogously, total collagen concentration in the anastomotic wounds decreased postoperatively and were lower (P = 0.043) in the male compared with the female rats on day 3. MMP-9 levels increased in the anastomoses postoperatively, but they did not differ (P = 0.391) between male and female animals. Soluble collagen levels were lower in the day-3 anastomoses of male versus female rats (P = 0.015) and correlated positively with total TGF-β1 levels (rS = 0.540, P = 0.006). Although TGF-β1 tended to be lower in male compared with the female rats, the differences did not reach statistical significance. Conclusion: Our findings point towards a less favorable collagen metabolism in colonic anastomoses of male compared with female rats during early wound healing.
AB - Purpose: Clinically, male patients subjected to colorectal surgery are more prone to develop anastomotic leakage than female patients by unknown mechanisms. Our aim was to investigate the impact of gender on anastomotic wound healing using an experimental model. Methods: One-layer colonic anastomosis was constructed in 8-week-old 28 male and 32 female Sprague-Dawley rats. Animals of one group (n = 30) were sacrificed immediately after surgery day 0 and the other group (n = 30) on postoperative day 3. Anastomotic breaking strength, total collagen (hydroxyproline), soluble collagen (Sircol), matrix metalloproteinase (MMP)-9, and transforming growth factor (TGF)-β1 were measured. Results: The anastomotic breaking strength decreased from day 0 to day 3 with no significant gender differences either in the extent of decline (P = 0.122) or absolute day 3 strengths (P = 0.425). Analogously, total collagen concentration in the anastomotic wounds decreased postoperatively and were lower (P = 0.043) in the male compared with the female rats on day 3. MMP-9 levels increased in the anastomoses postoperatively, but they did not differ (P = 0.391) between male and female animals. Soluble collagen levels were lower in the day-3 anastomoses of male versus female rats (P = 0.015) and correlated positively with total TGF-β1 levels (rS = 0.540, P = 0.006). Although TGF-β1 tended to be lower in male compared with the female rats, the differences did not reach statistical significance. Conclusion: Our findings point towards a less favorable collagen metabolism in colonic anastomoses of male compared with female rats during early wound healing.
KW - Anastomotic leakage
KW - Androgens
KW - Breaking strength
KW - Collagen
KW - Colorectal surgery
KW - Gender differences
U2 - 10.1007/s00384-018-3089-4
DO - 10.1007/s00384-018-3089-4
M3 - Journal article
C2 - 29850942
AN - SCOPUS:85047796196
SN - 0179-1958
VL - 33
SP - 1269
EP - 1276
JO - International Journal of Colorectal Disease
JF - International Journal of Colorectal Disease
IS - 9
ER -