The effects of octreotide on healing of small bowel anastomosis.

Octreotide (OCT) is a somatostatin analog used for its inhibitory action on multiple GI functions. Although octreotide has numerous clinical benefits, it has also been shown to inhibit postresectional hyperplasia of small bowel and hepatic regeneration. Because octreotide inhibits both trophic and anabolic hormones, we hypothesize that the use of octreotide may be detrimental in patients with a recent bowel anastomosis. To test this hypothesis, 60 male rats were randomized to four equal groups following small bowel anastomosis. Group I = control; Group II = 10 mg/day of hydrocortisone succinate; Group III = 2.5 micrograms/kg/day octreotide (equivalent of a clinical dose); Group IV = 25 micrograms/kg/day octreotide. Hydrocortisone was used as a negative control because it is known to have inhibitory effects on small bowel anastomotic healing. On postoperative Day 7, bursting pressures were measured. Serum T-kininogen levels, as a marker for systemic inflammation, and hydroxyproline content from the anastomotic segments were obtained. These results indicate that in the rat small bowel model, octreotide did not have any deleterious effect on anastomotic strength, systemic inflammation, and collagen content, even at high doses. Hydrocortisone, as expected, showed significant detrimental effects on bursting strength, as well as decreasing systemic inflammation. These findings have significant clinical implications, as octreotide could be used without jeopardizing the intestinal anastomosis.