Sleeve gastrektomi yapılan ratlarda anostomoz hattına uygulanan epidermal growth faktörün anostomoz güvenliği üzerine etkisi
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Tarih
2021
Yazarlar
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Yayıncı
Selçuk Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Sleeve gastrektomi günümüzde oldukça sık yapılan bir cerrahi yöntemdir ve önemli komplikasyonlarından biri kesi hattından kaçak meydana gelmesidir. Günümüzde kesi hattını güçlendirmek için çeşitli yöntemler denenmektedir. EGF hücrelerin bölünmesi, farklılaşması, yaşaması, çoğalması, büyümesi ve hücre göçünü uyaran protein yapıda bir büyüme faktörü olup, organizmadaki pek çok fizyolojik ve patolojik süreçte rol almaktadır. Bu etkilerinden dolayı EGF'nin anastomoz iyileşmesine katkı sağlayıp, stapler hattını güçlendireceği düşünülerek böyle bir çalışma planlanmıştır. Bu çalışmada ratlar üzerinde uygulanan deneysel sleeve gastrektomi modelinde, suturasyonun(klinik uygulamada stapler hattına kanama durdurucu ve stapler hattını destekleme amaçlı uygulanan suturasyon) ve yara iyileşmesinde kullanılan EGF'nin anastomoz iyileşmesine etkisi ve birbirlerine üstünlükleri araştırılmıştır. Çalışmada, ağırlıkları 300-350 gram arasında değişen, 16 haftalık 30 adet dişi Wistar türü albino rat kullanıldı. Ratlar randomize 3 gruba ayrıldı. Üç gruba da 30mm'lik lineer stapler yardımıyla sleeve gastrektomi uygulandı. A grubunda stapler hattına herhangi bir destekleyici madde uygulanmadı. B grubunda anastomoz hattına suturasyon uygulandı. C grubunda anastomoz hattına Rekombinant Human Epidermal Growth Faktör (rhEGF) uygulandı. Ratlar 6.gün de sakrifiye edildi ve anastomoz patlama basınçları ölçüldü, anastomoz üzerinden alınan doku örneğinden histopatolojik inceleme yapıldı. Veriler PASW 22 (SPSS/IBM, Chicago, IL, USA) eşliğinde incelendi. EGF'nin mide anastomoz iyileşmesi üzerine etkisi; anastomoz patlama basıncı, histopatolojik skorlamalar üzerinden değerlendirilmiştir. Gruplar doku histopatolojik inceleme açısından değerlendirildiğinde istatistiksel olarak anlamlı fark gözlenmedi. Ancak, anostomoz basıncı açısından değerlendirildiğinde A ve B gruplarının ortalama basınçları birbirine yakın ve C grubundan daha düşük olduğu gözlendi ve istatiksel olarak anlamlı veri elde edildi. Bu verilere göre EGF'nin mide anastomoz iyileşmesi üzerine olumlu etkileri olduğunu söyleyebiliriz. Bu sonuçlar sleeve gastrektomide stapler hattına destekleyici olarak EGF'nin kullanılabileceği yönünde güçlü veriler sağlamaktadır. Çalışmamızda patlama basıncı ve histopatolojik olarak yara iyileşmesinin değerlendirilmesiyle, EGF'nin kontrol grubuna göre stapler hattında yara iyileşmesini ve patlama basıncını artırdığı dolayısıyla doku direnci ve dayanıklılığını sağladığı görüldü. Sonuç olarak sleeve gastrektomide stapler hattı üzerine EGF kullanımının stapler hattı iyileşmesini arttıracağı görülmüş ve bu çalışmanın klinik prospektif çalışmalarla desteklenmesi gerektiği düşünülmüştür.
Sleeve gastrectomy is a very common surgical method today and one of its important complications is leakage from the incision line. Today, various methods are being tried to strengthen the incision line. EGF is a protein-structured growth factor that stimulates cell division, differentiation, survival, proliferation, growth and cell migration, and plays a role in many physiological and pathological processes in the organism. Due to these effects, such a study was planned considering that EGF will contribute to anastomosis healing and strengthen the stapler line. In this study, in the experimental sleeve gastrectomy model applied on rats, the effect of suturing- suturing applied to the stapler line in clinical practice to stop the hemorrhage and to support the stapler line- and EGF used in wound healing on anastomosis healing and their advantages over each other were investigated. In the study, 30 female Wistar type albino rats weighing between 300-350 grams, 16 weeks old, were used. Rats were randomly divided into 3 groups. Sleeve gastrectomy was performed with the help of a 30mm linear stapler in all three groups. supporting substance was not applied to the stapler line in group A. In group B, suturing was applied to the anastomosis line. Recombinant Human Epidermal Growth Factor (rhEGF) was applied to the anastomosis line in group C. The rats were sacrificed on the 6th day and their anastomotic bursting pressures were measured, and histopathological examination was performed from the tissue sample taken from the anastomosis. The data were analyzed with PASW 22 (SPSS / IBM, Chicago, IL, USA). The effect of EGF on stomach anastomosis healing; The anastomotic bursting pressure was evaluated by histopathological scores. When the groups were evaluated in terms of tissue histopathological examination, statistically significant difference was not observed. However, when evaluated in terms of anostomosis pressure, it was observed that the mean pressures of groups A and B were close to each other and lower than group C, and statistically significant data were obtained. According to these data, we can say that EGF has positive effects on stomach anastomosis healing. These results provide strong data that EGF can be used to support the stapler line in sleeve gastrectomy. As a result of our study, it was observed that EGF increased wound healing in the stapler line compared to the control group, by evaluating the burst pressure and histopathological wound healing. As a result, it was seen that the use of EGF on the stapler line in sleeve gastrectomy would increase the stapler line healing and it was thought that this should be supported by clinical prospective studies on humans.
Sleeve gastrectomy is a very common surgical method today and one of its important complications is leakage from the incision line. Today, various methods are being tried to strengthen the incision line. EGF is a protein-structured growth factor that stimulates cell division, differentiation, survival, proliferation, growth and cell migration, and plays a role in many physiological and pathological processes in the organism. Due to these effects, such a study was planned considering that EGF will contribute to anastomosis healing and strengthen the stapler line. In this study, in the experimental sleeve gastrectomy model applied on rats, the effect of suturing- suturing applied to the stapler line in clinical practice to stop the hemorrhage and to support the stapler line- and EGF used in wound healing on anastomosis healing and their advantages over each other were investigated. In the study, 30 female Wistar type albino rats weighing between 300-350 grams, 16 weeks old, were used. Rats were randomly divided into 3 groups. Sleeve gastrectomy was performed with the help of a 30mm linear stapler in all three groups. supporting substance was not applied to the stapler line in group A. In group B, suturing was applied to the anastomosis line. Recombinant Human Epidermal Growth Factor (rhEGF) was applied to the anastomosis line in group C. The rats were sacrificed on the 6th day and their anastomotic bursting pressures were measured, and histopathological examination was performed from the tissue sample taken from the anastomosis. The data were analyzed with PASW 22 (SPSS / IBM, Chicago, IL, USA). The effect of EGF on stomach anastomosis healing; The anastomotic bursting pressure was evaluated by histopathological scores. When the groups were evaluated in terms of tissue histopathological examination, statistically significant difference was not observed. However, when evaluated in terms of anostomosis pressure, it was observed that the mean pressures of groups A and B were close to each other and lower than group C, and statistically significant data were obtained. According to these data, we can say that EGF has positive effects on stomach anastomosis healing. These results provide strong data that EGF can be used to support the stapler line in sleeve gastrectomy. As a result of our study, it was observed that EGF increased wound healing in the stapler line compared to the control group, by evaluating the burst pressure and histopathological wound healing. As a result, it was seen that the use of EGF on the stapler line in sleeve gastrectomy would increase the stapler line healing and it was thought that this should be supported by clinical prospective studies on humans.
Açıklama
Anahtar Kelimeler
Sleeve Gastrektomi, Anostomoz, Epidermal Growth Faktör, Sleeve Gastrectomy, Anostomosis, Epidermal Growth Factor
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Kök, H. (2021). Sleeve gastrektomi yapılan ratlarda anostomoz hattına uygulanan epidermal growth faktörün anostomoz güvenliği üzerine etkisi. (Uzmanlık Tezi). Selçuk Üniversitesi, Tıp Fakültesi, Konya.
