Copyright
©The Author(s) 2021.
World J Gastrointest Surg. Dec 27, 2021; 13(12): 1736-1753
Published online Dec 27, 2021. doi: 10.4240/wjgs.v13.i12.1736
Published online Dec 27, 2021. doi: 10.4240/wjgs.v13.i12.1736
Ref. | Country | Animal model (race) | Sample size (n) | Number of groups (n) | Animal per group (n) | Day at animal sacrification | Underlying animal condition that PRP was tested | PRP amount in anastomosis (and factors mixed with PRP) | Control | Primary comparison |
Daglioglu et al[9], 2018 | Turkey | Rat (Winstar-Albino) | 36 | 3 | 12 | Day 7 | Normal | 0.5 mL PRP | Simple end-end colon anastomosis | PRP vs fibrin glue |
Ocak et al[34], 2019 | Turkey | Rat (Winstar-Albino) | 35 | 3 | 10 | Day 7 | Hyperthermic intraperitoneal chemotherapy (HIPEC) | 200 μL PRP (200 μL thrombin and 100 μL calcium solution) | Hyperthermic saline after anastomosis | PRP vs non PRP application in rats having HIPEC with cisplatin |
Yol et al[10], 2008 | Turkey | Rat (Sprague Danwley) | 30 | 3 | 10 | Day 7 | Normal | 1 mL PRP (0.1 mL thrombin and 1 mL calcium solution) | Simple end-end colon anastomosis | PRP vs bioglue |
Buk et al[35], 2020 | Turkey | Rat (Winstar-Albino) | 35 | 3 | 10 | Day 7 | HIPEC | 1 mL PRP (1 mL thrombin and 0.5 mL calcium solution) | Hyperthermic saline after anastomosis | PRP vs non PRP application in rats having HIPEC with oxaliplatin |
Dzhumabekov et al[25], 2019 | Kazakhstan | Rabbit (Chinchillas) | 81 | 3 | 27 | Day 7 | Normal | 0.2 mL/m2 PRP | Normal saline injected in the muscular layer of end-end small bowel anastomosis | PRP injection in bowel muscular layers vs soaking of bowel edges in PRP before anastomosis |
Aydin et al[17], 2020 | Turkey | Rat (Sprague Dawley) | 24 | 3 | 8 | Day 7 | Normal | 0.7 μL PRP absorbed by sutures | Simple end-end colon anastomosis | Higher vs lower platelet concentration PRP-impregnated vicryl sutures |
Dauser et al[26], 2020 | Austria | Pig | 16 | 4 | 4 | Day 0, 4, 10 and 30 | Normal | PRF spray | Each group had one animal as a control: A simple anastomosis was performed with a circular stapler | PRF vs no PRF application tested in several postoperative days |
Giusto et al[28], 2017 | Italy | Pig (Landace X Large White) | 8 | 2 | 4 | Day 8 | Normal | 1 mL PRP (50 μL calcium solution) | 2 out of 6 anastomoses performed in each animal used as a control anastomosis [no PRP or platelet rich in growth factors (PRGF) applied] | PRP vs PRGF |
Zhou et al[29], 2014 | China | Rat (Sprague Dawley) | 30 | 3 | 10 | Day 7 | Open abdomen. A polypropylene mesh used for abdomen closing in the open abdomen group | 1 mL PRP | Simple end-end colon anastomosis | PRP vs non PRP application in a background of open abdomen |
Göksu et al[30], 2020 | Turkey | Rat (Wistar Albino) | 24 | 3 | 8 | Day 7 | HIPEC | PRP alone (dose not mentioned) | Hyperthermic saline after anastomosis | PRP vs non PRP application in rats having HIPEC with 5-fluorouracil (5-FU) |
Özçay et al[16], 2018 | Turkey | Rat (Sprague Dawley) | 40 | 4 | 10 | Day 7 | Mesenteric ischemia/reperfusion injury (IR injury) | PRF membrane applied around the anastomosis | Simple end-end colon anastomosis | PRF vs non PRF application following IR injury |
Fresno et al[19], 2010 | Spain | Pig (White) | 35 | 7 | 3 or 10 | Day 1, 2, 3, 4 and 7 | Normal | 1 mL PRP (50 μL calcium solution) | 1 out of 2 anastomoses performed in each animal used as a control anastomosis (no PRP or PRGF applied) | PRP effect on several postoperative days |
Daradka et al[27], 2019 | Jordan | Rabbit (mixed-breed) | 30 | 3 | 10 | Day 3 and 10 | Normal | Sutures submerged in 1 ml PRP solution | Simple end-end ileal anastomosis | PRP vs sodium citrate coated sutures |
Yalı et al[36], 2020 | Turkey | Rat (Wistar-Albino) | 56 | 4 | 12 | Day 5 | Peritonitis | 1 mL PRP (1 mL calcium solution) | Simple end-end colon anastomosis | PRP in normal abdomen vs peritonitis |
Pehlivanli et al[33], 2019 | Turkey | Rat (Wistar Albino) | 55 | 5 | 10 | Day 10 | Mesenteric ischemia | 1 mL PRP | Simple end-end colon anastomosis | PRP vs Zeolite vs thymoquinone |
Sozutek et al[31], 2016 | Turkey | Rat (Wistar Albino) | 50 | 4 | 10 | Day 7 | Peritonitis | 1 mL PRP (1 mL thrombin and 50 μL calcium solution) | Simple end-end colon anastomosis | PRP in normal abdomen vs peritonitis |
Yamaguchi et al[18], 2012 | Japan | Rat (Sprague-Dawley) | 77 | 4 | 12 | Day 5 | Normal | 180 μL PRP (180 units of bovine thrombin and 30 μL of calcium solution). | Simple end-end colon anastomosis | Platelet poor plasma vs low vs high platelet rich plasma |
Gorur et al[32], 2020 | Turkey | Rat (Wistar Albino) | 50 | 4 | 10 | Day 7 | Intraperitoneal administration of 5-FU | 1 mL PRP (1 mL thrombin and 50 μL of calcium solution) | Simple end-end colon anastomosis | PRP vs non PRP application in rats having intraperitoneal administration of 5-FU |
Ref. | Anastomotic burst pressure (mm/hg) | Tissue hydroxyproline (μg/mg) | Collagen deposition | Inflammatory cells deposition | ||||||
PRP | Control | Other agent | P value | PRP | Control | Other agent | P value | |||
Daglioglu et al[9], 2018 | 146 ± 44.55 mm/hg | 119 ± 35.65 mm/hg | 149.1 ± 72.29 mm/hg (Fibrin glue) | vs Control (0.026); vs Fibrin glue (0.896) | 120.1 ± 51.5 μg/mg | 96.2 ± 29.22 μg/mg | 118.71 ± 42.18 μg/mg | vs Control (0.023); vs Fibrin glue (0,745) | No significant difference between groups | No significant difference between groups |
Ocak et al[34], 2019 | 146 ± 21.85 mm/hg | 180 ± 9.14 mm/hg | 115.8 ± 18.19 mm/hg (HIPEC with cisplatin group) | vs Control (< 0.001); vs HIPEC with cisplatin (0.01) | 256.59 ± 84.03 ng/mg | 314.69 ± 47.56 ng/mg | 148.02 ± 26.57 ng/mg (HIPEC with cisplatin) | vs Control (0.335); vs Hyperthermic saline group (< 0.001) | - | Inflammatory cell infiltration is significant decreased with PRP application in HIPEC and cisplatin model |
Yol et al[10], 2008 | 270 ± 29.8 mm/hg | 195 ± 15.3 mm/hg | 214 ± 16.46 mm/hg (bioglue) | vs Control (< 0.001); vs Bioglue (< 0.001) | 18.2 ± 4.95 μg/mg | 10.96 ± 5.94 μg/mg | 11.08 ± 5.08 μg/mg | vs Control (0.016); vs Bioglue (0.026) | Rich collagen production was observed in the PRP group. No comparison between groups | Less inflammatory cell infiltration in the PRP group |
Buk et al[35], 2020 | 125.7 ± 15.64 mm/hg | 180 ± 9.14 mm/hg | 94.90 ± 9.9 mm/hg (HIPEC with oxiliplatin) | vs Control (< 0.001); vs HIPEC with oxiliplatin group (< 0.0011) | 280.92 ± 45.85 ng/mg | 314.69 ± 75.57 ng/mg | 92 ± 26.97 ng/mg (HIPEC with oxiliplatin) | vs Control (< 0.001); vs HIPEC with oxiliplatin) (< 0.0011) | - | Inflammatory cell infiltration is significant decreased with PRP application in oxiplatin model |
Dzhumabekov et al[25], 2019 | 1.76 ± 0.28 (PRP soakinggroup)1 | 1.54 ± 0.231 | 1.81 ± 0.171 (PRP injecting group) | vs Control (0.05); vs PRP injecting group (0.69) | - | - | - | - | No significant differences between groups | Inflammatory cell infiltration significantly lower in the PRP soaking or injection group |
Aydin et al[17], 2020 | 121 ± 57 mm/hg | 124 ± 61 mm/hg | 180 ± 49 mm/hg (low concentration PRP) | vs Control (> 0.05); vs low concentration PRP (< 0.0011) | 0.39 ± 0.10 μg/mg | 0.25 ± 0.17 μg/mg | 0.56 ± 0.37 μg/mg (low concentration PRP) | vs Control (< 0.001); vs low concentration PRP (< 0.051) | - | No significant difference between groups |
Dauser et al[26], 2020 | Median = 210 mm/hg (day 10) | Median = 60 mm/hg (day 10) | - | The study reports no statistically significant changes between groups due to small sample size | - | - | - | - | Matrix treated animals showed less immature collagen deposition (type III) compared to the control group (day 10). However no significant differences were observed | No significant changes in the M2 or non-M2 macrophage density in the mucosal, mural and serosal layers. No significant changes in inflammatory cell infiltration |
Giusto et al[28], 2017 | 117.5 mm/hg (range: 80-190) | 154 mm/hg (range: 50-180) | 165 mm/hg (range: 100-190) (PRGF); And 175 mm/hg (range: 160-190) (intact bowel) | vs Control or PRGF (> 0.05); vs Intact bowel (0.00071) | - | - | - | - | No significant difference between groups | No significant difference between groups |
Zhou et al[29], 2014 | 177 ± 6.95 mm/hg | 184.8 ± 6.6 mm/hg | 158 ± 5.08 mm/hg (open abdomen group without PRP application) | vs Control (0.398); vs non-PRP application in open abdomen (0.041) | 399.7 ± 9.46 μg/mg | 403.6 ± 8.55 μg/mg | 353.5 ± 6.75 μg/mg (open abdomen group without PRP application) | vs Control (0.74); vs non-PRP application in open abdomen (0.001) | Significantly higher in the PRP and control group | No significant differences between groups |
Göksu et al[30], 2020 | 143 ± 17.35 mm/hg | 150 ± 20.49 mm/hg | 119.38 ± 17.65 mm/hg (5-FU HIPEC without PRP application) | vs Control (0.718); vs non-PRP 5-FU HIPEC (0.047) | 253.64 ± 5.35 μg/mg | 259.6 ± 7.95 μg/mg | 244.04 ± 7.28 μg/mg (5-FU HIPEC without PRP application) | vs Control (0.224); vs non-PRP 5-FU HIPEC (0.03) | - | Decreased lymphocytes in the PRP compared to the other groups. No statistically significant changes in neutrophil infiltration |
Özçay et al[16], 2018 | 198.1 ± 36.5 mm/hg | 205.1 ± 41.1 mm/hg | 106.1 ± 33.9 mm/hg (IR injury without PRF) | vs Control (> 0.05); vs non PRF in IR injury (< 0.01) | - | - | - | - | Moderate to severe collagen deposition in all groups but no significant changes between groups | Moderate to severe cellular infiltration but no significant changes between groups |
Fresno et al[19], 2010 | 1.34 ± 0.07 kgf 1(day 3); 1.14 ± 0.11 kgf 1(day 7) | 1.21 ± 0.08 kgf 1(day 3); 1.08 ± 0.08 kgf 1(day 7) | 1.8 ± 0.08 kgf 1(normal tissue) | vs Normal tissue (< 0.05); vs Control day 3 or 7 (> 0.05) | - | - | - | - | No significant difference between groups | - |
Daradka et al[27], 2019 | 60.2 ± 5.5 mm/hg | 54.5 ± 7.5 mm/hg | 55.6 ± 10.2 mm/hg (sodium citrate coated sutures) | vs Control (0.211) | 0.76 ± 0.1 μg/mg | 0.47 ± 0.13 μg/mg | 0.52 ± 0.07 μg/mg (sodium citrate- coated sutures) | vs Control (< 0.05) on day 10; vs Control (> 0.05) on day 3 | Statistically significant higher collagen deposition compared to uncoated suture groups on day 10 | Statistically significant less inflammatory infiltration compared to PRP uncoated suture groups |
Yalı et al[36], 2020 | 129.66 ± 26.6 mmH20 | 143.25 ± 37.47 mmH20 | 154.9 ± 27.64 mmH20 (colon anastomosis in peritonitis) and 173.5 ± 29.49 mmH20 (colon anastomosis and PRP application in peritonitis) | vs Control (> 0.05); vs Colon anastomosis and PRP application in peritonitis (< 0.05) | - | - | - | - | Statistically significant higher collage storage values in PRP treated group compared to control and peritonitis model | Statistically significant differences between groups in terms of inflammatory reaction |
Pehlivanli et al[33], 2019 | 225 (range: 180-250)2 | 200 (range: 90-230)2 | 235 (range: 220-250)2 thymoquinone; 132.5 (range: 85-150)2 Zeolite | vs Control (> 0.05); vs Zeolite (< 0.05); vs Thymoquinone (> 0.05) | 613.22 (range: 158.55-801.82)2 | 371.27 (range: 164.51-785.45)2 | 473.03 (range: 215.33-963.43)2 thymoquinone; 459.15 (range: 182.44-738.21)2 Zeolite | vs Control (> 0.05); vs Zeolite (> 0.05); vs Thymoquinone (> 0.05) | - | No significant difference in terms of inflammation at the anastomotic line in between groups |
Sozutek et al[31], 2016 | 209 ± 14.4 mm/hg | 179.5 ± 10.3 mm/hg | 129.3 ± 14.2 mm/hg (colon anastomosis in peritonitis); 167.5 ± 7.5 mm/hg (colon anastomosis and PRP application in peritonitis) | vs Control (0.01); vs Colon anastomosis in peritonitis (0.01); vs Colon anastomosis and PRP application in peritonitis (0.01) | 17.4± 1.21 μg/mg | 10.8± 0.67 μg/mg | 8.98 ± 1.04 μg/mg (colon anastomosis in peritonitis); 10.6 ± 0.52 μg/mg (colon anastomosis and PRP application in peritonitis) | vs Control (0.023); vs Colon anastomosis in peritonitis (0.01); vs Colon anastomosis and PRP application in peritonitis (0.012) | Application of PRP in peritonitis group did no increase collagen deposition significantly | Macrophages significantly increased in PRP vs control group and lymphocytes were significantly decreased in PRP + peritonitis compared to peritonitis group |
Yamaguchi et al[18], 2012 | 148 ± 25 mm/hg (H-PRP) | 171 ± 20 mm/hg | 174 ± 23 mm/hg (PPP); 189 ± 17 mm/hg (L-PRP) | vs Control (< 0.05); vs L-PRP (< 0.05); vs PPP (< 0.05) | 407 ± 143 μg/mg | 515 ± 130 μg/mg | 495 ± 123 μg/mg (PPP); 629 ± 120 μg/mg (L-PRP) | vs Control (< 0.05); vs L-PRP (< 0.05); vs PPP (< 0.05) | In L-PRP more collagen deposition in the serosa layer compared to other groups. H-PRP showed the lesser collagen deposition compared to other groups | - |
Gorur et al[32], 2020 | 246.7± 25.1 mm/hg | 232.6± 19.5 mm/hg | 127.5± 17.7 mm/hg (colon anastomosis and 5-FU intraperitoneal); 202.9 ± 28.8 mm/hg (colon anastomosis + PRP and 5-FU intraperitoneal) | vs Control (> 0.05); vs Colon anastomosis and 5-FU intraperitoneal (< 0.05); Colon anastomosis + PRP vs non PRP and 5-FU intraperitoneal (< 0.05) | 1939.5 ± 586 μg/mg | 2994.6 ± 2132.4 μg/mg | 591 ± 84.4 μg/mg (colon anastomosis and 5-FU intraperitoneal); 1171 ± 301.7 μg/mg (colon anastomosis + PRP and 5-FU intraperitoneal) | vs Control (0.212); vs Colon anastomosis and 5-FU intraperitoneal (< 0.05); Colon anastomosis + PRP vs non PRP and 5-FU intraperitoneal (< 0.05) | Increased but no statistically significant collagen deposition in colon anastomosis + PRP vs non PRP on a background of intraperitoneal 5-FU administration | No significant differences between groups |
Groups | Necrosis | Neutrophil | Lymphocyte | Macrophages | Oedema | Mucosal epithelium | Submucosal layer | Bridging | Total |
Ocak et al[34] | |||||||||
Control | 2.3 ± 0.82 | 2.5 ± 0.52 | 2.5 ± 0.52 | 2.5 ± 0.52 | 2.9 ± 0.31 | 2.6 ± 0.966 | 0.8 ± 0.63 | - | - |
PRP | 2.6 ± 0.69 | 2.8 ± 0.42a | 2.7 ± 0.48a | 2.7 ± 0.48a | 2.9 ± 0.31 | 2.6 ± 0.516 | 1.4 ± 0.69 | - | - |
Fibrin glue | 2 ± 0.66 | 2.1 ± 0.31a | 2.1 ± 0.31a | 2.1 ± 0.31a | 2 ± 0.47 | 2.6 ± 0.516 | 1.3 ± 0.67 | - | - |
Buk et al[35] | |||||||||
Control | 2.3 ± 0.82 | 1.9 ± 0.56a | 1.8 ± 0.42a | 2 ± 0.47 | 2.1 ± 0.56a | 2.6 ± 0.966 | 0.8 ± 0.63a | - | - |
Oxaliplatin | 2.5 ± 0.52 | 2.9 ± 0.52a | 2.4 ± 0.51a | 2.5 ± 0.52 | 2.8 ± 0.42a | 2.6 ± 0.516 | 2 ± 0.94a | - | - |
Oxaliplatin + PRP | 2.7 ± 0.58 | 2 ± 0.47a | 1.8 ± 0.42a | 2.3 ± 0.67 | 2.1 ± 0.56a | 2.5 ± 0.54 | 1.6 ± 0.96a | - | - |
Aydin et al[17] | |||||||||
Control | 1 ± 1 | 2 ± 1 | - | 2 ± 0 | 2 ± 1 | 3 ± 1 | 3 ± 0 | - | - |
L-PRP | 0 ± 2 | 2 ± 1 | - | 2 ± 0 | 1 ± 0a | 2.5 ± 1a | 3 ± 2 | - | - |
H-PRP | 1.5 ± 2 | 2 ± 2 | - | 2 ± 1 | 0 ± 0a | 1 ± 2a | 3 ± 0 | - | - |
Göksu et al[30] | |||||||||
Control | 2.38 ± 0.51 | 2.38 ± 0.518 | 2.38 ± 0.51a | - | 2.75 ± 0.46a | 2.63 ± 0.51 | 1.75 ± 0.46 | - | - |
5-FU | 2.63 ± 0.51 | 2.50 ± 0.463 | 2.63 ± 0.51a | - | 2.75 ± 0.46a | 2.50 ± 0.53 | 1.25 ± 0.46 | - | - |
5-FU + PRP | 2.13 ± 0.35 | 2.13 ± 0.518 | 2 ± 1a | - | 2 ± 0.53a | 2.63 ± 0.51 | 1.25 ± 0.46 | - | - |
Sozutek et al[31] | |||||||||
Control | 0.3 ± 0.48 | 1.3 ± 0.94 | 1 ± 0.47 | 1 ± 0a | 0.4 ± 0.51 | 0.3 ± 0.48 | - | 0.6 ± 0.51 | 4.9 ± 1.28 |
Control + PRP | 0.2 ± 0.42 | 0.7 ± 0.67 | 1 ± 0.47 | 1.6 ± 0.51a | 0.3 ± 0.48 | 0.4 ± 0.48 | - | 0.2 ± 0.42 | 4.3 ± 1.33 |
Septic | 1.1 ± 0.64 | 1.5 ± 0.53 | 1.6 ± 0.51a | 1.1 ± 0.83 | 1.2 ± 0.71a | 1 ± 0.53 | - | 1.2 ± 0.71 | 9.8 ± 1.12a |
Septic + PRP | 0.7± 0.48 | 1.2 ± 0.42 | 1.3 ± 0.48a | 1.5 ± 0.52 | 0.4 ± 0.51a | 0.5 ± 0.51 | - | 0.8 ± 0.42 | 6.1 ± 1.37a |
Gorur et al[32] | |||||||||
Control | 0.3 ± 0.67a | 1.3 ± 0.9 | 1 ± 0.47 | 1 ± 0 | 1.1 ± 0.31a | 0.3 ± 0.57a | - | 1.2 ± 0.78a | - |
5-FU | 1 ± 1.05a | 1.5 ± 0.53 | 1.4 ± 0.32 | 1.1 ± 0.83 | 2 ± 0.73a | 1.1 ± 0.42a | - | 1.5 ± 0.52a | - |
Control + PRP | 0a | 0.7 ± 0.67 | 1 ± 0.67 | 1.8 ± 0.31 | 1 ± 0.47a | 0.3 ± 0.57a | - | 0.9 ± 0.87a | - |
5-FU + PRP | 0.1 ± 0.3 | 1.2 ± 0.42 | 1.5 ± 0.58 | 1.6 ± 0.53 | 1.7 ± 0.48 | 0.6 ± 0.57 | - | 1.1 ± 0.31 | - |
- Citation: Geropoulos G, Psarras K, Giannis D, Martzivanou EC, Papaioannou M, Kakos CD, Pavlidis ET, Symeonidis N, Koliakos G, Pavlidis TE. Platelet rich plasma effectiveness in bowel anastomoses: A systematic review. World J Gastrointest Surg 2021; 13(12): 1736-1753
- URL: https://www.wjgnet.com/1948-9366/full/v13/i12/1736.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v13.i12.1736