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Eur J Cardiothorac Surg 2006;30:840-845
© 2006 Elsevier Science NL

The effects of granulocyte colony-stimulating factor on the healing of tracheal anastomosis following radiation therapy in rats

Akn Kuzucu^a, Haldun ükrü Erkal^b,_*, Hale Krmlolu^c, Kadir Batçolu^d, Neslihan Yücel^e, Meltem Serin^b

^a Department of Thoracic Surgery, nönü University Faculty of Medicine, Malatya, Turkey
^b Department of Radiation Oncology, nönü University Faculty of Medicine, TR-44280 Malatya, Turkey
^c Department of Pathology, nönü University Faculty of Medicine, Malatya, Turkey
^d Department of Biochemistry, nönü University Faculty of Pharmacy, Malatya, Turkey
^e Department of Emergency Medicine, nönü University Faculty of Medicine, Malatya, Turkey

Received 9 December 2005; received in revised form 12 September 2006; accepted 20 September 2006.

^_* Corresponding author. Fax: +90 422 341 00 36. (Email: hserkal{at}inonu.edu.tr).

Objective: This study evaluates the effects of granulocyte colony-stimulating factor on the healing of tracheal anastomosis following radiation therapy in rats. Methods: Fifty-six male Wistar rats were divided into four groups. Group 1 underwent tracheal anastomosis. Group 2 underwent radiation therapy followed by tracheal anastomosis. Group 3 underwent radiation therapy followed by tracheal anastomosis and received granulocyte colony-stimulating factor. Group 4 underwent sham radiation therapy followed by sham tracheal anastomosis. At 10 days following radiation therapy, the trachea was dissected for histopathological, mechanical and biochemical evaluation. Results: Median scores for inflammation were three points for Group 1, two points for Group 2, two points for Group 3 and one point for Group 4. Median scores for angiogenesis were four points for Group 1, two points for Group 2, three points for Group 3 and one point for Group 4. Median scores for connective tissue regeneration were four points for Group 1, two points for Group 2, three points for Group 3 and one point for Group 4. Median scores for epithelial regeneration were two points for Group 1, one point for Group 2, one point for Group 3 and one point for Group 4. Mean anastomotic bursting pressures were 853 mmHg for Group 1, 293 mmHg for Group 2, 417 mmHg for Group 3 and 966 mmHg for Group 4. Mean hydroxyproline concentrations were 159 µg/mg for Group 1, 177 µg/mg for Group 2, 120 µg/mg for Group 3 and 117 µg/mg for Group 4. Conclusions: This study suggests that granulocyte colony-stimulating factor contributes to the healing of tracheal anastomosis following radiation therapy through improved connective tissue regeneration.

Key Words: Trachea • Anastomosis • Radiation therapy • Granulocyte colony-stimulating factor • Rats