Is combined therapy more effective than growth hormone or hyperbaric oxygen alone in the healing of left ischemic and non-ischemic colonic anastomoses?

Clinics (Sao Paulo). 2013 Nov;68(11):1440-5. doi: 10.6061/clinics/2013(11)10.


Objective: Our aim was to investigate the effects of growth hormone (GH), hyperbaric oxygen and combined therapy on normal and ischemic colonic anastomoses in rats.

Methods: Eighty male Wistar rats were divided into eight groups (n = 10). In the first four groups, non-ischemic colonic anastomosis was performed, whereas in the remaining four groups, ischemic colonic anastomosis was performed. In groups 5, 6, 7, and 8, colonic ischemia was established by ligating 2 cm of the mesocolon on either side of the anastomosis. The control groups (1 and 5) received no treatment. Hyperbaric oxygen therapy was initiated immediately after surgery and continued for 4 days in groups 3 and 4. Groups 2 and 6 received recombinant human growth hormone, whereas groups 4 and 8 received GH and hyperbaric oxygen treatment. Relaparotomy was performed on postoperative day 4, and a perianastomotic colon segment 2 cm in length was excised for the detection of biochemical and mechanical parameters of anastomotic healing and histopathological evaluation.

Results: Combined treatment with hyperbaric oxygen and GH increased the mean bursting pressure values in all of the groups, and a statistically significant increase was noted in the ischemic groups compared to the controls (p<0.05). This improvement was more evident in the ischemic and normal groups treated with combined therapy. In addition, a histopathological evaluation of anastomotic neovascularization and collagen deposition showed significant differences among the groups.

Conclusions: Combined treatment with recombinant human growth hormone and hyperbaric oxygen resulted in a favorable therapeutic effect on the healing of ischemic colonic anastomoses.

Publication types

  • Comparative Study

MeSH terms

  • Anastomosis, Surgical
  • Animals
  • Collagen / analysis
  • Colon / blood supply
  • Colon / pathology
  • Colon / surgery*
  • Combined Modality Therapy
  • Disease Models, Animal
  • Human Growth Hormone / therapeutic use*
  • Hyperbaric Oxygenation / methods*
  • Ischemia / therapy*
  • Male
  • Necrosis
  • Neovascularization, Physiologic
  • Pressure
  • Rats
  • Rats, Wistar
  • Reproducibility of Results
  • Treatment Outcome
  • Wound Healing / drug effects*


  • Human Growth Hormone
  • Collagen