Praagh, J. van (Jasper) (2014) Voorspellende waarden in darmweefsel op het optreden van klinische naadlekkage bij colorectale chirurgische ingrepen. thesis, Medicine.
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Abstract
Background: Anastomotic leakage after colorectal surgery is a severe complication, leading to morbidity, reinterventions, prolonged hospital stay and, in some cases, even death. Though, early stages of anastomotic leakages are hard to detect. The aim of this study is to find molecular biological factors in the bowel that could predict the development of anastomotic leakage. Factors like Matrix MetalloProteinases (MMP’s) and the intestinal microbiome. Methods: Tissue of the bowel was peroperatively collected during a multicentre trial (Csealtrial). RNA and DNA were isolated from these samples, of which gene-expression of multiple MMP’s and the presence of bacteria has been investigated. Furthermore, immunohistochemical stainings on these samples with MMP-antibodies were performed. Results and Conclusion: Gene-expression of multiple MMP’s (MMP-1, -2, -3, -9, -14, -19 en -25) has been found in the samples of all patients. MMP-1 showed a significant difference (P<0.01) between the two research groups, with the gene-expression in the control group higher than in the group with patients developing anastomotic leakage. Additional to that, we found that a bacterial family, the Lachnospiraceae, was significantly correlated with the development of post-operative anastomotic leakage in our research groups. Also a correlation between these bacteria and an increased Body Mass Index (BMI) was found. Moreover, BMI also correlated with the development of anastomotic leakage. In conclusion, a high presence of Lachnospiraceae in the bowel tissue around the anastomosis may predispose the development of anastomotic leakage.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Olinga, Dr. P. and Havenga, Dr. K. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:44 |
| Last Modified: | 25 Jun 2020 10:44 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/567 |
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