Introduction: Intestinal transplantation (IT) is one of the important cause of intestinal ischemia and reperfusion injury. It is well known that anastomotic problems seen after IT are mainly related to reperfusion injury. Probiotics are non-pathogenic live microorganisms that are used for various bowel diseases due to their beneficial effects on bowel functions. Wound healing is an important bowel function and impaired healing is a series trouble after IT and ischemic bowel. In this study, we aimed to investigate the effect of probiotics on the intestinal anastomosis healing process.
Methods: Forty male SD rats were divided into four groups: Group I(n:10) colonic anastomosis only; Group II (n:10) colonic anastomosis after IR injury; Group III (n:10) probiotic and colonic anastomosis; Group IV (n:10) probiotic and colonic anastomosis after IR injury. Probiotics are given 250 million/day, po. The left colon was cut and anastomotised with continuous 6/0 nylon suture after 60 minutes of reperfusion. Animals were monitored for 7 days, then sacrificed. Macroscopic findings, anastomotic bursting pressures and histopathologic findings were evaluated.
Results: Probiotics were well tolerated in the treatment groups (Groups III and IV). Macroscopically, there were no anastomotic leaks or abscess formation in either of the probiotic groups (Groups III and IV). Anastomotic bursting pressures of probiotics groups tended to be highly compared with the ischemic control group (Group II), although the difference was not statistically significant. The histologic scores of probiotic groups were very similar to the control groups.
Conclusion: The probiotic groups had less adhesions according to the macroscopic findings; anastomotic bursting pressures tended to be high and histologically, they had equivalent healing scores compared with the control groups. We conclude that probiotics have some beneficial effect to impaired anastomotic healing processes , without any side effects on the colon in the colon. Therefore they might be considered as a supportive treatment in IT patients.
Key words: probiotics, ischemia and reperfusion injury, intestinal transplantation.