Eur Surg (2017) 49:158–164
Effects of papaverine on healing of colonic anastomosis in
Salim Ilksen Basceken · Yusuf Sevim
· Cihangir Akyol · Egemen Cicek · Ferit Aydın · Akin Firat Kocaay ·
Ozge Tugce Pasaoglu · Volkan Genc · Hatice Pasaoglu · Atil Cakmak
Received: 1 December 2016
Accepted: 25 May 2017
Published online: 12 June 2017
© Springer-Verlag Wien 2017
Background Anastomotic leak is the most devastating
complication after colorectal surgery, and the blood
supply is a very important factor in anastomotic heal-
ing. Papaverine is a vasodilatory and antispasmodic
agent which has been used in many ischemic condi-
tions because of its potentially protective effects. The
aim of this study is to investigate the effects of pa-
paverine on healing colon anastomosis.
Methods Forty 8- to 10-week-old female Wistar Albino
rats were used in this study. Rats were randomized
into 4 groups: control group; ischemia-reperfusion
Conception and design of the study: Salim Ilksen Basceken,
Atil Cakmak, Volkan Genc.
Acquisition of data, or analysis and interpretation of data:
Salim Ilksen Basceken, Yusuf Sevim, Akin Firat Kocaay, Ozge
Tugce Pasaoglu, Hatice Pasaoglu.
Drafting the article or revising it critically for important
intellectual content: Yusuf Sevim, Cihangir Akyol, Egemen
Cicek, Ferit Aydin.
Final approval of the version to be submitted: Atil Cakmak,
Cihangir Akyol, Volkan Genc.
S. I. Basceken, MD · C. Akyol, MD · F. Aydın, MD ·
A. F. Kocaay, MD · V. Genc, MD · A. Cakmak, MD
Department of General Surgery, Ankara University Medical
School, Ankara, Turkey
Y. Sevim, MD, FTBS (
Department of General Surgery, Division of Colorectal
Surgery, Ankara Numune Training and Research Hospital,
Hacettepe Mahallesi Talatpasa Bulvari No:44, 06100 Sihhiye
E. Cicek, MD
Department of General Surgery,
Inönü University Medical
School, Malatya, Turkey
O. T. Pasaoglu, PhD · H. Pasaoglu, PhD
Department of Biochemistry, Gazi University Medical
School, Ankara, Turkey
and anastomosis group; ischemia-reperfusion and
anastomosis + intraperitoneal one dose papaver-
ine group; and ischemia-reperfusion and anastomo-
sis + intraperitoneal daily (10 days) papaverine group.
Anastomotic bursting pressures, the hydroxyproline
measurements and macroscopic adhesion gradings
Results There was a signiﬁcant difference between pa-
paverine-administered groups and ischemia-reperfu-
sion and anastomosis group for anastomotic bursting
pressures, hydroxyproline measurements and macro-
scopic adhesion grading (p < 0.05).
Conclusion In the rat model, papaverine had a favor-
able effect on anastomotic healing.
Keywords Ischemia-reperfusion injury · Anastomotic
leak · Papaverine
Colorectal cancers, ischemic colitis, inﬂammatory
bowel diseases, mechanical intestinal obstruction,
trauma and recurrent diverticulitis are some indica-
tions of colorectal resections . Complication rates
range between 10% and 30% in colorectal surgery .
One of the most important complications of colorectal
surgery causing high morbidity and mortality is anas-
tomotic leak (AL). Ischemia, surgical technique, tense
anastomosis, local infections and distal obstruction
of anastomosis are some probable etiologic factors
of AL . In spite of surgical advances in colorectal
surgery, complication rates range from 5–15% . The
mortality rates of AL range between 10% and 32% in
Papaverine, an opium alkaloid which causes va-
sodilation, has been used clinically for many years.
There are numerous studies investigating the effects of
this nonspeciﬁc vasodilator in some vascular diseases
158 Papaverine and colonic anastomosis