Effects of Levosimendan on Anastomotic Healing in an Ischemic Colon Anastomosis Model

Abstract

Introduction: Anastomotic leakage following ischemic colon anastomosis poses significant morbidity and cost. Levosimendan, with inotropic and vasodilatory properties, may enhance healing. This study evaluated Levosimendan's effects on ischemic colon anastomosis in rats.

Methods: Sixty Wistar Albino rats underwent ischemic colon anastomosis and were randomized into six groups: fourth-day control, seventh-day control, fourth-day low-dose Levosimendan, seventh-day low-dose Levosimendan, fourth-day high-dose Levosimendan, and seventh-day high-dose Levosimendan. Anastomotic bursting pressure, myeloperoxidase, hydroxyproline levels, and histopathological changes were assessed.

Results: Levosimendan, particularly at low doses, significantly increased bursting pressure. The fourth-day low-dose group showed a median (Q1-Q3) bursting pressure of 98.00 (72.00-106.00) mmHg, compared to 53.00 (24.75-64.75) mmHg in the fourth-day control group (P = 0.001). The seventh-day low-dose group had a median (Q1-Q3) bursting pressure of 111.50 (96.50-154.00) mmHg, while the seventh-day control group had 91.00 (59.00-100.50) mmHg (P = 0.007). Histopathology revealed significant improvements in fibrosis (P = 0.020), ischemic necrosis (P < 0.001), and inflammatory cell infiltration in Levosimendan groups. Myeloperoxidase levels were significantly higher in the fourth-day low-dose group compared to the fourth-day control group (P = 0.041), while hydroxyproline levels showed no significant differences.

Conclusions: Levosimendan positively impacts ischemic colon anastomosis healing in rats, particularly at low doses.

Keywords: Anastomotic leakage; Ischemic colon anastomosis; Levosimendan.