Experimental study of the effect of preoperative 5‐fluorouracil on the integrity of colonic anastomoses

Background Despite curative resection for colorectal cancer, many patients develop recurrence at the primary site or distant organs. These patients are candidates for (neo)‐adjuvant chemotherapy. Very little is known about the effect of preoperative 5‐fluorouracil (FU) on the healing of colonic anastomoses. The aim of this study was to assess this in a rat model. Methods Eighty male Wistar rats, weighing 160–215 g, were divided into three groups; (1) a control group underwent left colon resection and primary anastomosis ( n = 20); (2) a sham group received 1 ml saline intraperitoneally ( n = 30); (3) a study group received 5‐FU intraperitoneally (20 mg kg −1 ). Both saline and 5‐FU injections were given intraperitoneally for 5 days before operation. Results There was no difference in the rate of wound complications, intraperitoneal adhesions and anastomotic complications among the groups. Three and seven days after operation, mean bursting pressure of the anastomosis was 36·5 and 198 mmHg in group 1, 34 and 200 mmHg in group 2, and 39 and 190 mmHg in group 3 respectively ( P not significant). Although the myeloperoxidase and hydroxyproline content were significantly lower after 5‐FU therapy ( P < 0·01, compared with others), the clinical outcome was similar. Conclusion Preoperative 5‐FU for 5 consecutive days before operation had no effect on the healing of colonic anastomoses. © 1998 British Journal of Surgery Society Ltd