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Influence of preoperative high-dose radiotherapy on postoperative outcome and colonic anastomotic healing: experimental study in the rat

Wim Ceelen UGent, M El Malt, Anne Cardon, Frederik Berrevoet UGent, Wilfried De Neve UGent and Piet Pattyn UGent (2001) DISEASES OF THE COLON & RECTUM. 44(5). p.717-721
abstract
PURPOSE: Surgical treatment of rectal cancer is followed by local recurrence in up to 30 percent of cases. Recently, preoperative low-dose radiotherapy has been shown to improve both local recurrence rate and overall survival. Down-staging of locally advanced tumors, however, requires preoperative doses of at least 50 to 60 Gy. Most experimental studies investigating the effect of preoperative radiotherapy have made use of a single dose or a limited number of fractionated doses. Moreover, in most studies, both Limbs of the anastomosis were irradiated, in contrast to clinical practice, in which one limb of the anastomosis consists of nonirradiated bowel. We studied the effect of a fractionated, clinically relevant scheme of high-dose preoperative radiotherapy on colonic anastomotic healing in the rat. METHODS: Male Wistar rats randomly received 0, 40, 60, or 80 Gy of preoperative radiotherapy on one limb of the anastomosis only. Radiotherapy doses were validated with implanted dosimeters; before the start of radiotherapy, the cecum was fixed outside the radiation field. A clinically used fractionation scheme of 2 Gy per day, 5 days per week for 4 to 8 weeks was used. The day after radiotherapy completion a side-to-side colorectal anastomosis was performed. Rats were killed 10 days after surgery. The following parameters were determined: presence of abscess or peritonitis, anastomotic complications (stenosis, leak, or dehiscence), intestinal obstruction, anastomotic bursting pressure, and anastomotic hydroxyproline content. RESULTS: No significant differences were found in peritonitis rate, anastomotic complications, anastomotic bursting pressure, or hydroxyproline content. Irradiated animals gained weight more slowly than the control group. CONCLUSION: In this rat model, preoperative high-dose radiotherapy using a clinically relevant fractionation scheme does not affect outcome or anastomotic healing when only one limb of the anastomosis is irradiated.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (proceedingsPaper)
publication status
published
subject
keyword
radiotherapy, rat, cancer, anastomosis, RECTAL-CANCER, MESORECTAL EXCISION, IRRADIATION, RADIATION
journal title
DISEASES OF THE COLON & RECTUM
Dis. Colon Rectum
volume
44
issue
5
pages
717 - 721
conference name
35th Congress of the European-Society-for-Surgical-Research
conference location
Malmö, Sweden
conference start
2000-06-01
conference end
2000-06-03
Web of Science type
Article
Web of Science id
000168650300020
JCR category
SURGERY
JCR impact factor
2.142 (2001)
JCR rank
20/138 (2001)
JCR quartile
1 (2001)
ISSN
0012-3706
DOI
10.1007/BF02234573
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
142573
handle
http://hdl.handle.net/1854/LU-142573
date created
2004-01-14 13:37:00
date last changed
2016-12-19 15:38:04
@article{142573,
  abstract     = {PURPOSE: Surgical treatment of rectal cancer is followed by local recurrence in up to 30 percent of cases. Recently, preoperative low-dose radiotherapy has been shown to improve both local recurrence rate and overall survival. Down-staging of locally advanced tumors, however, requires preoperative doses of at least 50 to 60 Gy. Most experimental studies investigating the effect of preoperative radiotherapy have made use of a single dose or a limited number of fractionated doses. Moreover, in most studies, both Limbs of the anastomosis were irradiated, in contrast to clinical practice, in which one limb of the anastomosis consists of nonirradiated bowel. We studied the effect of a fractionated, clinically relevant scheme of high-dose preoperative radiotherapy on colonic anastomotic healing in the rat. METHODS: Male Wistar rats randomly received 0, 40, 60, or 80 Gy of preoperative radiotherapy on one limb of the anastomosis only. Radiotherapy doses were validated with implanted dosimeters; before the start of radiotherapy, the cecum was fixed outside the radiation field. A clinically used fractionation scheme of 2 Gy per day, 5 days per week for 4 to 8 weeks was used. The day after radiotherapy completion a side-to-side colorectal anastomosis was performed. Rats were killed 10 days after surgery. The following parameters were determined: presence of abscess or peritonitis, anastomotic complications (stenosis, leak, or dehiscence), intestinal obstruction, anastomotic bursting pressure, and anastomotic hydroxyproline content. RESULTS: No significant differences were found in peritonitis rate, anastomotic complications, anastomotic bursting pressure, or hydroxyproline content. Irradiated animals gained weight more slowly than the control group. CONCLUSION: In this rat model, preoperative high-dose radiotherapy using a clinically relevant fractionation scheme does not affect outcome or anastomotic healing when only one limb of the anastomosis is irradiated.},
  author       = {Ceelen, Wim and El Malt, M and Cardon, Anne and Berrevoet, Frederik and De Neve, Wilfried and Pattyn, Piet},
  issn         = {0012-3706},
  journal      = {DISEASES OF THE COLON \& RECTUM},
  keyword      = {radiotherapy,rat,cancer,anastomosis,RECTAL-CANCER,MESORECTAL EXCISION,IRRADIATION,RADIATION},
  language     = {eng},
  location     = {Malm{\"o}, Sweden},
  number       = {5},
  pages        = {717--721},
  title        = {Influence of preoperative high-dose radiotherapy on postoperative outcome and colonic anastomotic healing: experimental study in the rat},
  url          = {http://dx.doi.org/10.1007/BF02234573},
  volume       = {44},
  year         = {2001},
}

Chicago
Ceelen, Wim, M El Malt, Anne Cardon, Frederik Berrevoet, Wilfried De Neve, and Piet Pattyn. 2001. “Influence of Preoperative High-dose Radiotherapy on Postoperative Outcome and Colonic Anastomotic Healing: Experimental Study in the Rat.” Diseases of the Colon & Rectum 44 (5): 717–721.
APA
Ceelen, Wim, El Malt, M., Cardon, A., Berrevoet, F., De Neve, W., & Pattyn, P. (2001). Influence of preoperative high-dose radiotherapy on postoperative outcome and colonic anastomotic healing: experimental study in the rat. DISEASES OF THE COLON & RECTUM, 44(5), 717–721. Presented at the 35th Congress of the European-Society-for-Surgical-Research.
Vancouver
1.
Ceelen W, El Malt M, Cardon A, Berrevoet F, De Neve W, Pattyn P. Influence of preoperative high-dose radiotherapy on postoperative outcome and colonic anastomotic healing: experimental study in the rat. DISEASES OF THE COLON & RECTUM. 2001;44(5):717–21.
MLA
Ceelen, Wim, M El Malt, Anne Cardon, et al. “Influence of Preoperative High-dose Radiotherapy on Postoperative Outcome and Colonic Anastomotic Healing: Experimental Study in the Rat.” DISEASES OF THE COLON & RECTUM 44.5 (2001): 717–721. Print.