Effects of thyroid hormone supplementation on anastomotic healing after segmental colonic resection

J Surg Res. 2012 Aug;176(2):460-7. doi: 10.1016/j.jss.2011.11.1015. Epub 2011 Dec 13.

Abstract

Background: Alterations of thyroid hormones in colorectal surgery were previously studied. The aim of the present study was to determine the effects of triiodothyronine (T3) supplementation on anastomotic healing after segmental colectomy.

Material and methods: Thirty male Wistar albino rats were divided into sham (n = 6), control (n = 12), and experimental (n = 12) groups. Sham group rats were immediately sacrificed after segmental colonic resection. Control and experimental group rats underwent resection and anastomosis. Experimental group rats received a single dose of T3 (400 μg/100 g) in postoperative day 1. Half of both control and experimental group rats were sacrificed on postoperative d 3 and the remaining half were sacrificed on postoperative d 7. Hydroxiproline (HP), myeloperoxidase (MPO), thyroid stimulating hormone (TSH), free T3 (FT3), and free thyroxine (FT4) levels, bursting pressure, and histologic analyses of the anastomotic segments were compared.

Results: FT3 levels significantly decreased in control groups rats compared with the sham group (P < 0.01). However, T3 hormone given rats had no decline in FT3 levels. Anastomotic bursting pressure was significantly higher in the experimental group rats on postoperative d 7 (P = 0.015). Histopathologic analyses of the anastomotic segments determined significantly more severe edema and necrosis in control group rats (P < 0.05). Collagen deposition in the anastomotic tissue was significantly higher in experimental group rats on postoperative d 7 (P = 0.015).

Conclusion: Anastomosis after colon resection is associated with decreased FT3 level. T3 supplementation ameliorates the reduction in FT3 and seems to provide constructive therapeutic effects on anastomotic healing.

MeSH terms

  • Anastomosis, Surgical / methods
  • Animals
  • Colectomy / methods*
  • Collagen / metabolism
  • Colon / drug effects*
  • Colon / surgery*
  • Dose-Response Relationship, Drug
  • Hydroxyproline / metabolism
  • Male
  • Peroxidase / metabolism
  • Postoperative Complications / drug therapy
  • Postoperative Complications / metabolism
  • Pressure
  • Rats
  • Rats, Wistar
  • Rupture
  • Thyrotropin / metabolism
  • Thyroxine / metabolism
  • Triiodothyronine / metabolism
  • Triiodothyronine / pharmacology*
  • Wound Healing / drug effects*

Substances

  • Triiodothyronine
  • Thyrotropin
  • Collagen
  • Peroxidase
  • Thyroxine
  • Hydroxyproline