The Role Of N-Acetyl Cysteine At Preventing The Effects Of Ischemia-Reperfusion Injury Healing In An Experimental Colonic Anastomosis

Abstract

Objective: Ischemia and reperfusion injury is one of the most critical problems in general surgery. Ischemia and reperfusion injury occurs by free oxygen radicals. In this study, we investigated the effect of N-acetyl cysteine (NAC), which is known to eliminate the harmful effects of free oxygen radicals, in ischemia reperfusion injury model on colonic anastomosis.

Method: Twenty-four female Wistar Albino rats weighing 180 to 220 g were used in the study. Group 1: the group which was performed colonic anastomosis. Group 2: the group which was performed colonic anastomosis along with 30 minutes of ischemia to superior mesenteric artery (SMA) and its branches and subsequently reperfusion. Group 3: the group which was performed colonic anastomosis along with 30 minutes of ischemia to SMA and its branches and subsequently reperfusion and treated with NAC on the 15th minute of ischemia. On the 6th day after the first operation, Anastomotic bursting pressures were measured by performing relaparotomy, and tissue samples were taken and sacrificed.

Results: When the groups were evaluated in terms of anastomotic bursting pressures, a decrease in anastomotic bursting pressure was observed in Group 2 compared to Group 1, but this decrease was not statistically significant (p> 0.05). An increase in anastomotic bursting pressure was observed in Group 3 compared to Group 1. This increase was found to be significant when evaluated statistically (p <0.05). An increase in anastomotic bursting pressure was observed in Group 3 compared to Group 2. This increase was also statistically significant. (p <0.01).

Discussion: In vitro studies have demonstrated the free radical removing effects and the inhibitory effects on the superoxide radical from activated neutrophils of NAC. As a result of several experimental studies, NAC has a positive impact on intestinal ischemia-reperfusion injury. As a result of our research, NAC has been shown to have a positive effect on wound healing of colon anastomosis in ischemia-reperfusion injury.