The role of vascular endothelial growth factor as a predictor of complicated appendicitis in animal model oryctolagus cuniculus

Abstract

BACKGROUND: Appendicitis is the most common abdominal disease that requires surgery in children. The mortality rate in appendicitis is greatly affected by rupture or leakage of the appendix. In establishing the diagnosis of appendicitis, several modalities are needed, namely, with a pediatric appendicitis score and ultrasound. In addition to operative measures, non-operative therapeutic research is also developing, especially for cases of appendicitis without complications. Pathologically, the occurrence of complications in appendicitis is influenced by good vascularization for tissue healing through the process of angiogenesis by vascular endothelial growth factor (VEGF). AIM: We aimed to see the effect of VEGF and folic acid levels on the occurrence of complicated appendicitis. METHODS: This research method is laboratory experimental design. A total of 32 rabbits used were male rabbits weighing 2500–3000 g that met the inclusion and exclusion criteria. Samples were examined for VEGF levels and then the appendix lumen was obstructed with Silk No.-O thread. Thirteen hours later, blood samples are taken back to check VEGF and folic acid (FA) levels and an appendectomy is performed for histopathological examination. RESULTS: There is a decrease of basal VEGF levels regarding histopathological results. In complicated appendicitis, the basal VEGF level was lower than acute appendicitis and normal; 8.61 (±4.87), 7.66 (±3.47), and 5.75 (±4.88), respectively. Similar trend was found in basal FA levels. In complicated appendicitis, it has a lower level than both acute appendicitis and normal; 2.00 (±2.08), 1.14 (±1.00), and 0.44 (±0.22) in order. However, there is no statistical significance in both trends (p = 0.775 and p = 0.058). CONCLUSION: There was a trend showing low value of VEGF and FA that were a predictor of appendicitis and complicated appendicitis. Unfortunately, no statistical significance was shown in this study.