Preoperative vitamin C supplementation improves colorectal anastomotic healing and biochemical parameters in malnourished rats

Int J Colorectal Dis. 2016 Nov;31(11):1759-1766. doi: 10.1007/s00384-016-2647-x. Epub 2016 Sep 10.

Abstract

Purposes: The objective of this study was to evaluate the effect of supplementation with vitamin C on intestinal anastomosis healing in malnourished rats.

Methods: Male Wistar rats were divided into three groups: (1) sham, well-nourished rats that received vehicle; (2) FR+Veh, rats that were subjected to food restriction and received vehicle; and (3) FR+VC, rats that were subjected to food restriction and received vitamin C. Four days before surgery, the animals received vitamin C (100 mg/kg/day) via gavage and underwent colon resection with anastomosis in a single plane. The survival rate of rats was monitored until day 7 after surgery. Regarding anastomosis tissues, we examined intra-abdominal adhesion index, hydroxyproline content, collagen density, inflammatory parameters, and oxidative damage to proteins and lipids.

Results: Malnutrition decreases body weight and increases mortality; the survival rate was 90 % in group 1, 60 % in group 2, and 80 % in group 3. Vitamin C was able to increase hydroxyproline concentration and density of collagen and decrease the intra-abdominal adhesion index, as well as the infiltration of neutrophils and oxidative damage to proteins in malnourished rats compared to group treated with vehicle.

Conclusions: Preoperative vitamin C supplementation can improve the intestinal anastomosis healing, biochemical alterations, and prolong survival in rats subjected to food restriction.

Keywords: Inflammation; Intestinal anastomosis; Malnutrition; Oxidative stress; Vitamin C.

MeSH terms

  • Anastomosis, Surgical
  • Animals
  • Ascorbic Acid / administration & dosage
  • Ascorbic Acid / pharmacology
  • Ascorbic Acid / therapeutic use*
  • Body Weight / drug effects
  • Collagen / metabolism
  • Colon / drug effects
  • Colon / pathology
  • Colon / surgery*
  • Dietary Supplements*
  • Hydroxyproline / metabolism
  • Male
  • Malnutrition / complications
  • Malnutrition / drug therapy*
  • Nitrates / metabolism
  • Nitrites / metabolism
  • Oxidative Stress / drug effects
  • Peroxidase / metabolism
  • Preoperative Care*
  • Rats, Wistar
  • Rectum / drug effects
  • Rectum / pathology
  • Rectum / surgery*
  • Tissue Adhesions / complications
  • Tissue Adhesions / drug therapy
  • Tumor Necrosis Factor-alpha / metabolism
  • Wound Healing / drug effects*

Substances

  • Nitrates
  • Nitrites
  • Tumor Necrosis Factor-alpha
  • Collagen
  • Peroxidase
  • Ascorbic Acid
  • Hydroxyproline