PERI-OPERATIVE EFFECTS OF ROFECOXIB (SELECTIVE CYCLOOXYGENASE-2-INHIBITOR) ON COLONIC ANASTOMOSIS IN RATS

Document Type : Original Article

Authors

1 Departments of General Surgery, Mansoura University, Egypt

2 Histology and Cytology, Mansoura University, Egypt

3 Clinical Pharmacology, Faculty of Medicine, Mansoura University, Egypt

Abstract

Rofecoxib (selective cyclo-oxygenase-2-inhibitor) had a wide range of surgical therapies especially (analgesic) in the 
peri-operative period. Its effects on the intestinal wound healing is unknown. The aim of the studied was to investigate 
effects of Rofecoxib on colonic anastomosis in rats in the first post-operative week. 
The study included 40 male rats divided into two groups, studied, 20 and control 20. In both, resection-anastomosis of left colon with interrupted single layer of vicryl 6/0 was done. The control group received distilled water and the studied group received Rofecoxib pre-operatively and during the first post-operative week. 
Bursting pressure of the anastomosis in the studied group decreased from 116.40 + 10.20mmHg preoperatively to 41.60 + 3.00 mmHg and 49.40 + 5.79 mmHg respectively at 3 and 7 days post-operatively (P<0.001) compared to 124.05 + 11.15 mmHg, 107.70 + 12.90 mmHg and 114.55 + 12.91 mmHg respectively in the control group at the same intervals. Epithelialization of grade I with numerous inflammatory cells was noted in the anastomosis in the studied group at the third post-operative day, while epithelialization of grade III and less numerous inflammatory cells together with reformed lamina propria and congested blood vessels were noted at the seventh post-operative day. 
Incidence of colonic of fistula was 33% in the studied group versus 9% in the control group at the seventh post-operative day. 
While mortality was 25% in the studied group compared to 9% in the control group at the seventh post-operative day. No fistula or mortality occurred on the third post-operative day. 
In conclusion, administration of Rofecoxib significantly impaired healing (decreased cellular proliferation and collagen 
deposition) and decreased bursting pressure of colonic anastomosis in rats during the first post-operative week. Rofecoxib increased incidence of fistula in this period. 

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