Tesis

Efek Eksosom pada Anastomosis Usus Model Tikus Sprague Dawley = Effects of Exosomes on a Sprague Dawley Rat Model with Intestinal Anastomosis.

Latar belakang: Anastomosis usus pada bedah pediatri merupakan prosedur yang dapat berisiko menimbulkan komplikasi seperti kebocoran, striktur, dan fibrosis berlebih, memerlukan terap i adjuvan untuk optimasi fase inflamasi-proliferatif. Metode: Desain eksperimental post-test only control group dengan 18 tikus jantan Sprague Dawley (8-12 minggu, 250-350g), dirandomisasi ke tiga kelompok: kontrol, Surgicel saja, Surgicel+eksosom, dievaluasi hari ke-3 (inflamasi) dan hari ke-7 (proliferasi)tion. Parameter: fibrosis (Masson's Trichrome, ImageJ), skor histologi melalui hematoksilin eosin(HE) , vascular endothelial growth factor (VEGF) dan platelet-derived growth factors (PDGF). Hasil: Pada hari ke 3 pasca operasi tidak terdapat perbedaan rerata fibrosis antar kelompok kontrol, surgicel, surgicel eksosom P=0,53. Pada hari ke 7 juga tidak terdapat perbedaan signirikan rerata antar kelompok kontrol, surgicel, surgicel eksosom (P=0,61). Pada skor histologi pembesaran 400x, 100x dan 40x hari ke 3 dan ke 7 tidak terdapat perbedaan signifikan antar kelompok perlakuan anastomosis usus (P > 0,05). Rerata VEGF menunjukkan perbedaan signifikan (P=0,019) antar kelompok pada hari ke 3 (kontrol 31,73 ± 18,52, surgicel 34,66±2,87, surgicel eksosom 2,06±1,50. VEGF Hari ke 7 tidak menunjukkan perbedaan signifikan antar perlakuan (P=0,97). Rerata PDGF hari ke 3 tidak ada perbedaan signifikan antar kelompok P=0,26 sedangkan pada hari ke 7 nilai PDGF kontrol 159±7,51, surgicel 32,86±26,16,surgicel eksosom 118,40±53,97 terdapat perbedaan signifikan antar kelompok (P=0,012). Kesimpulan: Eksosom Surgicel menunjukkan tren perbaikan fibrosis/histologi melalui supresi bifasik VEGF dan stabilisasi PDGF potensi reduksi dehiscensice anastomosis usus.
Kata kunci: eksosom, anastomosis usus, VEGF, PDGF, surgicel


Background : Intestinal anastomosis in pediatric surgery carries a risk of complications such as leakage, stricture, and excessive fibrosis, and therefore requires adjuvant therapies to optimize the inflammatory and proliferative phases of wound healing. Methods: This was a post-test only control group experimental study involving 18 male Sprague–Dawley rats (8–12 weeks, 250–350 g) randomized into three groups: control, surgicel alone, and surgicel plus exosomes. Evaluations were performed on day 3 (inflammatory phase) and day 7 (proliferative phase). Assessed parameters included fibrosis (Masson’s trichrome, quantified with ImageJ), histological score using hematoxylin–eosin (HE), vascular endothelial growth factor (VEGF), and platelet-derived growth factor (PDGF). Results: There was no difference in fibrosis level 3 days post anastomosis between the control group, surgicel, and surgicel-exosome groups (P = 0.53). On the 7th day, there was also no significant difference in the mean values among the control, surgicel, and surgicel-exosome groups (P = 0.61). In the histological scores at 400x, 100x, and 40x magnifications on both day 3 and day 7, there were no significant differences among the intestinal anastomosis treatment groups (P > 0.05).The mean VEGF showed a significant difference (P = 0.019) among groups on day 3 (control: 31.73 ± 18.52, surgicel: 34.66 ± 2.87, surgicel-exosome: 2.06 ± 1.50). VEGF levels on day 7 did not show a significant difference among treatments (P = 0.97). The mean PDGF on day 3 showed no significant difference among groups (P = 0.26), while on day 7, PDGF values were control: 159 ± 7.51, surgicel: 32.86 ± 26.1 6, and surgicel-exosome: 118.40 ± 53.97, showing a significant difference among groups (P = 0.012). Conclusion: intestinal anastomoses treated with exosomes plus surgicel showed a trend toward improved fibrosis and histological profiles through biphasic VEGF suppression and PDGF stabilization, suggesting a potential reduction in the risk of anastomotic dehiscence.
Keywords: Exosomes, intestinal anastomosis, VEGF, PDGF, surgicel