Abstract
The effect of growth hormone on the bursting strength of left colonic anastomoses was investigated experimentally. Seventy-two 3 month-old female rats were randomized into two groups receiving daily injection of either saline (controls) or 2.0 mg biosynthetic human growth hormone per kg body weight per day. All injections were started 7 days before a left colonic resection and anastomosis, and continued until sacrifice at the 2nd, 4th or 6th post-operative day. The bursting strength of the anastomoses was tested in anaesthetized, living rats. The bursting pressure and the bursting wall tension of the growth hormone treated animals were increased two-fold on the second post-operative day (2p<0.005) and three-fold on the fourth post-operative day (2p<0.05), compared with controls. There was no difference in the bursting pressure or the bursting wall tension on the sixth postoperative day. The mass of the resected segment was incresed by the pre-operative growth hormone treatment, whereas the hydroxyproline content was unchanged. In conclusion, treatment with biosynthetic human growth hormone increases the strength of colonic anastomoses in the early phases of healing.
Similar content being viewed by others
References
Goligher JC, Graham NG, DeDombal FT (1970) Anastomotic dehiscence after anterior resection of rectum and sigmoid. Br J Surg 57:109–118
Debas HT, Thomson FB (1972) A critical review of colectomy with anastomosis. Surg Gynecol Obstet 135:747–752
Ravo B (1988) Colorectal anastomotic healing and intracolonic bypass procedure. In: Ravo B, Khubchandani IT (eds) The surgical clinics of North America. W. B. Saunders, Philadelphia, pp 1267–1294
Fielding LP, Steward-Brown S, Blesovsky L, Kearney G (1980) Anastomotic integrity after operations for large-bowel cancer: a multicenter study. Br Med J 281:411–414
Dunphy JE (1970) The cut gut. Am J Surg 19:1–8
Foster ME, Leaper DJ (1984) The alimentary tract. In: Bucknall TE, Ellis H (eds) Wound healing for surgeons. Balliére Tindall, London, pp 161–179
Schrock TR, Deveney CW, Dunphy JE (1973) Factors contributing to leakage of colonic anastomoses. Ann Surg 177:513–518
Cronin K, Jackson DS, Dunphy JE (1968) Changing bursting strength and collagen content of the healing colon. Surg Gynecol Obst 126:747–753
Stromberg BV, Klein LR (1982) Collagen formation during the healing of colonic anastomoses. Dis Colon Rectum 25:301–304
Wise L, McAlister W, Stein T, Schuck P (1975) Studies on the healing of anastomoses of small and large intestine. Surg Gynecol Obst 141:189–194
Hendriks T, Vereecken THLB, Hesp WLEM, Schillings PHM, deBoer HHM (1985) Loss of collagen from experimental intestinal anastomoses: early events. Exp Molec Pathol 42:411–418
Clemmons DR, Shaw DS (1986) Purification and biological proporties of fibroblast somatomedin. J Biol Chem 261:10293–10298
Johnson LR (1987) Regulation of gastrointestinal growth. In: Johnson LR (ed.) Physiology of the gastrointestinal tract. Raven, New York, pp 301–333
Lobie PE, Breipohl W, Waters MJ (1990) Growth hormone receptor expression in the rat gastrointestinal tract. Endocrinology 126:299–306
Jorgensen PH, Andreassen TT (1988) The influence of biosynthetic human growth hormone on biomechanical properties and collagen formation in granulation tissue. Horm Metabol Res 20:490–493
Udén P, Blomquist P, Jiborn H, Zederfeldt B (1988) Left colon anastomotic healing following colostomy closure. Acta Chir Scand 154:127–132
Jiborn H, Ahonen J, Zederfeldt B (1978) Healing of experimental colonic anastomoses. Am J Surg 136:587–594
Woessner JF (1976) Determination of hydroxyproline in connective tissues. In: Hall DA (ed) The methodology of connective tissue research. Joynson-Bruvvers, Oxford pp 227–233
Christensen H, Jorgensen PH, Oxlund H, Laurberg S (1990) Growth hormone increases the mass, the collagenous proteins and the strength of rat colon. Scand J Gastroenterol (in press)
Jönsson K, Jiborn H, Zederfelt B (1986) Mechanical and biomechanical alterations in the intestinal wall adjecent to an anastomosis. Am J Surg 151:387–390
Jiborn H (1978) Healing of left colonic anastomoses. An experimental study in the rat. Thesis, University of Lund, Malmö
Hollander DM, Devereux DF, Marafino BJ, Hoppe H (1984) Increased wound breaking strength in rats following treatment with synthetic human growth hormone. Surg Forum 35:612–614
Bak B, Jorgensen PH, Andreassen TT (1990) Dose response of growth hormone on fracture healing in the rat. Acta Orthop Scand 61:54–57
Jorgensen PH, Andreassen TT (1988) Influence of biosynthetic human growth hormone on the biomechanical properties of rat skin incisional wounds. Acta Chir Scand 154:623–626
Daughaday WH, Hall K, Raben MS, Salmon WD, Van den Brande JL, Van Wyk JJ (1972) Somatomedin: proposed disignation for sulphation factor. Nature 235:107–110
Manson JMcK, Wilmore DW (1986) Positive nitrogen balance with growth hormone and hypocaloric intravenous feeding. Surgery 100:188–197
Thorner ME, Vance LM, Rogol AD, Blizzard RM, Klingensmith G (1987) Some physiological and therapeutic considerations of GHRH in the regulation of growth. In: Isakson O, Binder C, Hall K, Hökfelt B (eds) Growth hormone. Elsevier, Amsterdam New York Oxford, pp 153–162
Wright PD, Johnston IDA (1975) The effect of surgical operation on growth hormone levels in plasma. Surgery 77:479–486
Ward HC, Halliday D, Sim AJW (1985) The effect of biosynthetic human growth hormone on protein metabolism in surgical patients. Br J Surg 72 (abstract):403
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Christensen, H., Oxlund, H. & Laurberg, S. Growth hormone increases the bursting strength of colonic anastomoses. Int J Colorect Dis 5, 130–134 (1990). https://doi.org/10.1007/BF00300401
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00300401