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Effect of Paclitaxel-based Hyperthermic Intraperitoneal Chemotherapy (HIPEC) on colonic anastomosis in a rat model

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Abstract

Background

Paclitaxel has been used frequently for Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for ovarian carcinomatosis. Cytoreductive surgery and HIPEC are associated with high rates of morbidity being anastomotic dehiscence one of the most frequent. The objective of this study is to quantify the effect of Paclitaxel-based HIPEC on colonic anastomosis in an experimental rat model.

Methods

After left colon resection and anastomosis, animals were randomized into four groups: Controls (C); Hyperthermia (H); Normothermic Intraperitoneal Paclitaxel (CP) and Paclitaxel-based HIPEC (HP). On postoperative day four, animals’ peritoneal cavities were examined macroscopically, colon anastomosis burst pressures measured and specimens analyzed histologically.

Results

Thirty-nine animals were randomized and 36 were included in the analysis. H group presented the highest burst pressure 105.11 ± 22.9 mmHg, which was 27% higher than C (77.89 ± 27.6 mmHg). On the other hand, HP presented the lowest burst pressure 64 ± 26 mmHg, 16% lower than C group and 39% lower than H, being this latter difference statistically significant (p = 0.004). There were no significant differences regarding weight loss, adhesion scores, perianastomotic abscesses and histological findings (inflammation, fibroblasts, neoangiogenesis, and collagen among groups).

Conclusion

Strength of colonic anastomosis was improved by isolated hyperthermia and negatively affected by Paclitaxel-based HIPEC.

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Authors and Affiliations

  1. Virgen de la Arrixaca Clinic and University Hospital, General Surgery, IMIB, El Palmar, Murcia, Spain

    V. López-López, J. Gil, M. García-Salom, E. Gil & P. A. Cascales-Campos

  2. Surgery Department, New York University School of Medicine, New York, NY, USA

    P. B. Lynn

  3. Gerencia del Area de Salud III (Lorca), Murcia, Spain

    A. González

  4. Hospital Virgen del Castillo (Yecla), Murcia, Spain

    I. P. Muñoz

Authors
  1. V. López-López
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  2. P. B. Lynn
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  3. J. Gil
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  4. M. García-Salom
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  5. E. Gil
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  6. A. González
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  7. I. P. Muñoz
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  8. P. A. Cascales-Campos
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Correspondence to V. López-López.

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The authors declared no conflict of interest. No third-party financial funds or materials were accepted or necessary for the execution of this research project.

Research involving human participants and/or animals

Maintenance and care of all the animals included were according with national directives from the Protection commission and National Institute of health for laboratory animal.

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The research did not involve human participants.

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López-López, V., Lynn, P.B., Gil, J. et al. Effect of Paclitaxel-based Hyperthermic Intraperitoneal Chemotherapy (HIPEC) on colonic anastomosis in a rat model. Clin Transl Oncol 21, 505–511 (2019). https://doi.org/10.1007/s12094-018-1948-7

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  • DOI: https://doi.org/10.1007/s12094-018-1948-7

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