Influence of intraperitoneal therapy with mitomycin C adsorbed on activated carbon on anastomotic and wound healing in rats

In an effort to prevent intraperitoneal dissemination of gastric carcinoma, local chemotherapy with mitomycin C adsorbed to activated carbon (MMC-CH) has been implemented. Results of clinical studies showed improved survival and a reduced systemic toxicity after the use of prophylactic treatment with MMC-CH. A significantly higher rate of intraperitoneal septic complications following MMC-CH therapy was found. The aim of this study was to assess whether intraperitoneal MMC-CH affects wound healing or healing of intestinal anastomoses. Standardized laparotomy was performed in 77 rats. The examinations were performed in 27 animals in the control group, 24 animals in the charcoal group, and 26 animals in the MMC-CH group. The animals and groups were distributed randomly. After an ileal anastomosis was performed, MMC-CH, charcoal, or sodium chloride 0.9% was administered intraperitoneally. After 10 days, collagen content as well as bursting strength/pressure of the fasciotomy and the anastomotic site was examined. Body weight and blood parameters analyzed included hemoglobin level, white blood cell count, platelet count, and total protein. Concerning body weight and hematology, no significant changes were observed. Three of 26 animals in the MMC-CH group, 2/24 in the charcoal group and 1/27 in the control group developed an anastomotic leakage. The bursting pressure of the anastomoses and the bursting strength of the fasciotomy as well as the relative collagen content did not differ significantly after treatment with charcoal or mitomycin C compared to the control group. Local inflammation consisting of charcoal-laden granulomas was detected histologically in the MMC-CH group and to a lesser extent in the charcoal group. In conclusion, no significant influence of intraperitoneal mitomycin C adsorbed on activated charcoal, in terms of its effect systemically or its effect on wound healing, could be demonstrated as a result of slow release. Histological changes seen with the use of activated charcoal suggest that perhaps a more ideal absorbable carrier should be sought.