Evidence map›Paper›PMID 41263941›Full record

ArticlePediatric surgery international2025

Remote ischemic conditioning modulates the healing process after intestinal anastomosis.

Masahiro Shimizu, George Biouss, Jielin Yang, Naho Fujiwara, Bo Li, Carol Lee, Dorothy Lee, Felicia Balsamo, Fabiola Cassaro, Mina Yeganeh and 6 more

Abstract read
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In one paragraph

Article in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Masahiro Shimizu *Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
George Biouss *The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Jielin YangThe Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Naho FujiwaraDepartment of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Bo LiThe Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Carol LeeThe Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Dorothy LeeThe Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Felicia BalsamoThe Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Fabiola CassaroThe Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Mina YeganehThe Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Andrea ZitoThe Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Naoki HashizumeThe Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Koshiro SugitaThe Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Go MiyanoDepartment of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Atsuyuki YamatakaDepartment of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Agostino PierroThe Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. agostino.pierro@sickkids.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate whether remote ischemic conditioning (RIC) improves intestinal anastomotic healing through modulation of different healing phases.

methodsJuvenile mice underwent distal ileal end-to-end anastomosis and were assigned to three groups: sham (laparotomy only), anastomosis only, and anastomosis + RIC. RIC involved four cycles of 5-minute hindlimb ischemia and 5-minute reperfusion, applied immediately postoperatively and repeated on postoperative days (POD) 2 and 4. On POD 2 and POD5, tissues were analyzed for TNF-α and IL-6 expression. On POD 5, bursting pressure, adhesion scores, and anastomotic complication scores were assessed. On POD2 and POD5, bulk RNA sequencing was conducted on intestinal anastomosis segments comparing anastomosis vs. sham and anastomosis vs. anastomosis + RIC .

resultsIncreased pro-inflammatory cytokine activity was observed on POD2 in the anastomotic site and the proximal area of the anastomosis, but not on POD5, indicating an initial phase of inflammation post anastomosis. No inflammation was found post-anastomosis in the distal area. Compared to anastomosis alone, RIC significantly reduced pro-inflammatory cytokine TNF-α and IL-6 gene and protein expression on in the anastomotic site and proximal area of anastomosis on POD 2 (qPCR), indicating decreased inflammation. Furthermore, functional analysis showed that on POD 5, the anastomosis + RIC group had significantly higher bursting pressure and lower adhesion scores compared to the anastomosis only group (p < 0.05). Bulk sequencing analysis showed an upregulation of inflammatory and apoptotic pathways in the anastomosis-only group, while RIC treated anastomosis group had upregulated wound healing pathways in the anastomotic site. These results suggested that RIC dampens early inflammation after intestinal anastomosis and improves the healing process in the anastomotic site.

conclusionRIC exerts phase-specific effects on anastomotic healing by attenuating early inflammation and enhancing mechanical strength. RIC may offer a simple and non-invasive strategy to improve surgical outcomes.

Indexed as

IleumIntestinesIschemic PreconditioningWound HealingAnastomosis, SurgicalAnimalsDisease Models, AnimalInterleukin-6MaleMiceMice, Inbred C57BLTumor Necrosis Factor-alphaInterleukin-6Tumor Necrosis Factor-alphaAdhesion formationBursting pressureHealing processInflammationIntestinal anastomosisRemote ischemic conditioning (RIC)

Identifiers

PMID41263941

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.