The Jejunoileal Bypass Provokes Morphological Changes In The Large Intestine? An Experimental Study In Rats [a Derivação Jejuno-ileal Provoca Alterações Morfológicas No Intestino Grosso? Estudo Experimental Em Ratos]

Purpose: To analyse histopathological alterations characterized by the mitotic index in the mucosa of the large intestine in Wistar rats submitted to jejunoileal bypass operation after continued administration of sodium nitrite and vitamin C to different groups. Methods: Eighty male Wistar rats were employed and separated into 12 groups. In the control group (20 rats): five animals ingested only water; five animals received vitamin C; five animals received sodium nitrite and five received sodium nitrite + vitamin C. In the sham group (20 rats), the animals were anesthetized and underwent midline laparotomy and only intestinal manipulation was performed: five animals ingested only water; five animals received vitamin C; five animals received sodium nitrite and five received sodium nitrite + vitamin C. In the operated group 40 rats underwent a jejunoileal bypass surgery: ten animals ingested only water; ten animals received vitamin C; ten animals received sodium nitrite and ten received sodium nitrite + vitamin C. The mean weight of the animals was measured weekly. The large intestine was subdivided into cecum (S1), ascending colon (S2), transverse colon (S3), descending colon (S4) and rectum (S5) for histopathological analysis and mitotic counts. The statistical analysis was used to compare the mitotic indices. The level of significance was 5%. Results: The mean of all the segments indicates that the sodium nitrite+vitamin C group obtained the lowest mitotic index compared to the other treatments in the control group. The segments S1 and S2 showed a statistical difference with the vitamin C treatment: a higher mitotic index and better preservation of the mucosa in the operated group. In the sham group the main statistical difference occurred only in the sodium nitrite+vitamin C group between the means of the segments. Conclusions: The comparison of all the colonic segments of the various groups revealed a lower mitotic index in the animals treated with sodium nitrite+vitamin C. In addition, it was found that vitamin C did not present a statistically significant inhibiting effect on the preservation of the mucosa and the mitotic index.276361369Joia-Neto, L., Lopes-Junior, A.G., Jacob, C.E., Digestive and metabolic changes in postoperative bariatric surgery (2010) ABCD Arq Bras Cir Dig, 23 (4), pp. 266-269Nassif, P.A.N., Lopes, A.D., Lopes, G.L., Martins, P.R., Pedri, L.E., Varaschim, M., Bopp, D.S., Changes in the pre-and postoperative parameters in metabolic syndrome patients submitted to Roux-en-Y gastric bypass (2009) ABCD Arq Bras Cir Dig, 22 (3), pp. 165-170Lemmens, V.E., Oenema, A., Klepp, K.I., Henriksen, J.H.B., Brug, J., A systematic review of the evidence regarding efficancy of obesity preventions among adults (2008) Obes Rev, 9 (5). , 446-445Chaib, S.A., Faria, R.M., Chaib, E., Mion Jr, D., Laudanna, A.A., Histopathological changes in the ileum and jejunum of patients subjected to a bypass operation for treatment of obesity (1983) Rev Hosp Clin Fac Med Sao Paulo, 38 (6), pp. 231-236Bristol, J.B., Wells, M., Williamson, R.C.N., Adaptation to jejunoileal bypass promotes experimental colorectal carcinogenesis (1984) Br J Surg, 71 (2), pp. 123-126Sylvan, A., Sjölund, B., Janunger, K.G., Rutegard, J., Steling, R., Roos, G., Colorectal cancer risk after jejunoileal bypass: Dysplasia and DNA content in longtime follow up of patients operated on for morbid obesity (1992) Dis Colon Rectum, 35 (3), pp. 245-248Kozoni, V., Tsioulias, G., Shiff, S., Rigas, B., The effect of litocholic acid on proliferation and apoptosis in the presence of a colon carcinogen (2002) Carcinogenesis, 21 (5), pp. 999-1005Scudamore, C.H., Freeman, H.J., Effects of small bowel transaction, resection, or bypass in 1,2 dimetilhidrazine induced rat intestinal neoplasia (1983) Gastroenterology, 84 (4), pp. 725-731Davis, K., Markov, M., Jasiurkowski, B., Ravi, J., Patel, P., Levater, R., Nadir, A., Van Thiel, D.H., Adenocarcinoma of the ileocecal valve occurring 35 years after jejunoileal bypass (2008) South Med J, 101 (7), pp. 772-773Petroianu, A., Alberti, L.R., Effect of oral suplementation of vitamin C on intestinal anastomotic resistance (2011) Rev Col Bras Cir, 38 (1), pp. 54-58Kuroiwa, Y., Yamada, M., Matsui, K., Okamura, T., Ishii, Y., Masumura, K., Tasaki, M., Nishikawa, A., Combined ascorbic acid and sodium nitrite treatment induces oxidative DNA damage-associated mutagenicity in vitro, but lacks initiation activity in rat forestomach epithelium (2008) Toxicol Sci, 104 (2), pp. 274-282Del-Rio, J.V., Beck, D.E., Opelka, F.G., Chronic perioperative steroids and colonic anastomotic healing in rats (1996) J Surg Res, 66, pp. 138-142Tylor, T.V., Rimmer, S., Day, B., Butccher, J., Dymock, I.W., Ascorbic acid supplementation in the treatment of pressure-sores (1974) Lancet, 2, pp. 544-546Kessler, H., Husemann, B., Wagner, W., Potential protective effect of vitamin C on carcinogenesis caused by nitrosamine in drinking water: An experimental study on Wistar rats (1992) Eur J Surg Oncol, 18, pp. 275-281Mokhtar, N.M., el-Aaser, A.A., el-Bolkainy, M.N., Ibrahim, H.A., Badr El-Din, N.K., Moharram, N.Z., Effect of soybean feeding on experimental carcinogenesis-III carcinogecity of nitrite and dibutylamine in mice: A histopathological study (1988) Eur J Cancer Clin Oncol, 24 (3), pp. 403-411Jordan, M.A., Mechanism of action of antitumor drugs that interact with microtubules and tubulin (2002) Curr Med Chem Anticancer Agents, 2 (1), pp. 1-17Teixeira, H.M., Ribas-Filho, J.M., Nassif, P.A.N., Dietz, U.A., Henriques, G.S., Aoki, S., Pizzol, F.D., Morphometric analysis of the large intestine mucosa after jejunal ileal bypass in rats (2006) ABCD Arq Bras Cir Dig, 19 (4), pp. 140-145McFarland, R.J., Talbot, R.W., Woolf, N., Gazet, J.C., Dysplasia of the colon after jejunoileal bypass (1987) Br J Surg, 74 (1), pp. 21-22Martinez Diez, M., Ingelmo, A., Castiella, T., Aguilella, V., Martinéz, F.G., Weight morphometric and morphodynamic intestinal changes after different types of experimental intestinal by-passes (1983) Rev Esp Enferm Apar Dig, 63 (4), pp. 305-316Martinez Diez, M., Aguilella, V., Cartiella, T., Ingelmo, A., Ortega, J., Martinez, F., González, M., Experimental evaluation of the importance of food reflux to the excluded intestine as a cause of the failure of the simple model of anti-obesity termino-lateral jejuno-ileal bypass. A weight-change, macroscopic, microscopic and ultrastructural study (1984) Rev Esp Enferm Apar Dig, 65 (1), pp. 15-27Tamames Jr, S., De Veja, D.S., Furio, V., Tamames, S., Compensatory reaction of the ascending colon following jejuno-ileal bypass (1990) Experimental study Rev Esp Enferm Dig, 78 (1), pp. 14-22De Vogel, J., van-Eck, W.B., Sesink, A.L., Janker-Termont, D.S., Kleibeuker, J., van der Meer, R., Dietary heme injures surface epithelium resulting in hiperproliferation, inhibition of apoptosis and crypt hyperplasia in rat colon (2008) Carcinogenesis, 29 (2), pp. 398-403Goodman, M., Bostick, R.M., Kucuk, O., Jones, D.P., Clinical trials of antioxidants as cancer prevention agents: Past, present and future (2011) Free Radic Biol Med, 51 (5), pp. 1068-1084Schectman, G., Estimating ascorbic acid requeriments for cigarette smokers (1993) Ann N Y Acad Sci, 686, pp. 335-345Ramos, A.C., Araujo, M.R., Lopes, L.R., Andreollo, N.A., Role of the vitamin C in diethylnitrosamine-induced esophageal cancer in Wistar rats (2009) Acta Cir Bras, 24 (3), pp. 183-188Larsson, S.C., Wolk, A., Meat consumption and risk of colorectal cancer: A meta-analysis of prospective studies (2006) Int J Cancer, 119 (11), pp. 2657-2664Institute: Surveillance epidemiology and end results, , http://seer.cancer.gov/statfacts/html/colorect.html#incidence-mortality, National Cancer Institute, Available fro