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| 1 | Pharmacological interventions for improved colonic anastomotic healing:A meta-analysis显示文摘AIM:To identify pharmaceuticals for the prophylaxis of anastomotic leakage(AL),we systematically reviewed studies on anastomosis repair after colorectal surgery.METHODS:We searched PubMed and EMBASE for articles published between January 1975 and December 2012.We included studies in English with the primary purpose of promoting healing of anastomoses made in the colon or rectum under uncomplicated conditions.We excluded studies on adverse events from interventions,nutritional interventions or in situ physical supporting biomaterials.The primary outcome was biomechanical strength or AL.We performed meta-analyses on therapeutic agents investigated by three or more independent research groups using the same outcome.The DerSimonian-Laird method for random effects was applied with P < 0.05.RESULTS:Of the 56 different therapeutic agents assessed,7 met our inclusion criteria for the metaanalysis.The prostacyclin analog iloprost increased the weighted mean of the early bursting pressure of colonic anastomoses in male rats by 60 mmHg(95%CI:30-89) vs the controls,and the immunosuppressant tacrolimus increased this value by 29 mmHg(95%CI:4-53) vs the controls.Erythropoietin showed an enhancement of bursting pressure by 45 mmHg(95%CI:14-76).The anabolic compound growth hormone augmented the anastomotic strength by 21 mmHg(95%CI:7-35),possibly via the up-regulation of insulin-like growth factor-1,as this growth factor increased the bursting pressure by 61 mmHg(95%CI:43-79) via increased collagen deposition.Hyperbaric oxygen therapy increased the bursting pressure by 24 mmHg(95%CI:13-34).Broad-spectrum matrix metalloproteinase inhibitors increased the bursting pressure by 48 mmHg(95%CI:31-66) on postoperative days 3-4.In the only human study,the AL incidence was not significantly reduced in the 103 colorectal patients treated with aprotinin(11.7%) compared with the 113 placebo-treated patients(9.7%).CONCLUSION:This systematic review identified only one randomized clinical trial and seven therapeutic agents from pre-clinical models that could be explored further for the prophylaxis of AL after colorectal surgery. | Mari Nanna φines Peter-Martin Krarup Lars Nannestad Jorgensen Magnus Sven Agren | 2014 | World Journal of Gastroenterology2014，20，35： | 5 |
| 2 | Expression and inhibition of matrix metalloproteinase (MMP)-8, MMP-9 and MMP-12 in early colonic anastomotic repair显示文摘 | Peter-Martin Krarup Mikkel Eld Katja Heinemeier Lars Nannestad Jorgensen Mark Berner Hansen Magnus S. ?gren | 2013 | International Journal of Colorectal Disease2013，，8： | 1 |
| 3 | What have we learned about generalized trust, if anything ? 显示文摘 | Nannestad P | 2008 | Annual Review of Political Science2008，11，1： | 1 |
| 4 | What Have We Learned about Generalized Trust, If Anything? 显示文摘 | Nannestad | 2008 | Annum Review of Political Sci- ence2008，，11： | 1 |
| 5 | Therapeutic improvement of colonic anastomotic healing under complicated conditions: A systematic review显示文摘AIM: To identify therapeutic agents for the prophylaxis of gastrointestinal anastomotic leakage(AL) under complicated conditions. METHODS: The Pub Med and EMBASE databases were searched for English articles published between January 1975 and September 2014. Studies with the primary purpose of improving anastomotic healing in the colon or rectum under complicated preoperative and/or intraoperative conditions were included. We excluded studies investigating the adverse effects or risk assessment of an active intervention. Furthermore, investigations of biophysical materials, sealants, electrical stimulation and nutrients were excluded. The primary study outcome was biomechanical anastomotic strength or AL. The meta-analysis focused on therapeutic agents that were investigated in one animal model using the same outcome by at least three independent research groups. RESULTS: The 65 studies included were divided into 7 different complicated animal models: Bowel ischemia, ischemia/reperfusion, bowel obstruction, obstructive jaundice, peritonitis, chemotherapy and radiotherapy. In total, 48 different therapeutic compounds were examined. The majority of investigated agents(65%) were reported as beneficial for anastomotic healing. Twelve of the agents(25%) were tested more than once in the same model, whereas 13(27%) of the agents were tested in two or more models of complicated healing. Two therapeutic agents met our inclusion criteria for the meta-analysis. Postoperative hyperbaric oxygen therapy significantly increased anastomoticbursting pressure in ischemic colon anastomoses by a mean of 28 mm Hg(95%CI: 17 to 39 mm Hg, P < 0.00001). Granulocyte macrophage-colony stimulating factor failed to show a significant increase in anastomotic bursting pressure(95%CI:-20 to 21 mmH g, P = 0.97) vs controls in experimental chemotherapeutic models. CONCLUSION: This systematic review identified potential therapeutic agents, but more studies are needed before concluding that any of these are useful for AL prophylaxis. | Malene Nerstrom Peter-Martin Krarup Lars Nannestad Jorgensen Magnus S Agren | 2016 | World Journal of Gastrointestinal Surgery2016，8，5： | 0 |
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