ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Do non-steroidal anti-inflammatory agents prevent stenotic complications of tracheal surgery? The effects of tenoxicam on tracheal healing
Suat Gezer1, Bekir Sami Karapolat1, Ümran Yıldırım2, Hayati Kandiş3, Leyla Yılmaz Aydın4
1Departments of Thoracic Surgery, Medical Faculty of Düzce University, Düzce
2Departments of Pathology, Medical Faculty of Düzce University, Düzce
3Departments of Emergency Medicine, Medical Faculty of Düzce University, Düzce
4Departments of Chest Diseases, Medical Faculty of Düzce University, Düzce
DOI : 10.5606/tgkdc.dergisi.2011.055
Background: Postoperative strictures, which are still serious problems of tracheal surgery, are caused by an inflammatory reaction with subsequent edema and granulation tissue formation. Taking this into consideration, we have designed a study in which tenoxicam (potent, non-steroidal, antiinflammatory drug) was used after a tracheal surgery in rats.

Methods: Fourteen female Wistar rats were randomly divided into two groups (tenoxicam and control group) with equal numbers. Ketamine-xylazine anesthesia was performed in the rats. A vertical incision on the anterior tracheal wall, including the third to fifth cartilaginous rings, was performed and closed primarily with an interrupted suture technique using 4/0 absorbable suture. The tenoxicam group was administered 0.5 mg/kg/day tenoxicam and the control group was given 0.5 cc/day 0.9% NaCl via intraperitoneal route for 10 days beginning from the operation day. After two weeks, all animals were sacrificed under general anesthesia. Tracheas were excised, and a pathologist blindly evaluated the cases. The Mann-Whitney U-test was used for statistical analysis, and a value of p<0.05 was considered significant.

Results: The rat specimens were histologically evaluated and scored for inflammatory cell infiltration, angiogenesis, fibroblast proliferation, collagen deposition, and epithelial regeneration. There were meaningful differences in fibroblast proliferation (p=0.036) and epithelial regeneration (p=0.002). These results show that epithelial regeneration was higher and fibroblast proliferation was lower in the tenoxicam group.

Conclusion: Increased fibroblastic activity causes stenosis after tracheal surgery and the application of tenoxicam diminishes fibroblast proliferation and improves epithelial healing. Therefore, postoperative non-steroidal anti-inflammatory drug usage might be a useful therapy in the prevention of stenotic complications after tracheal surgery. However, further studies are needed.

Keywords : Structure; tenoxicam; tracheal healing; tracheal surgery
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