Abstract
ObjectiveThe purpose of this study was to investigate the histological and morphological changes in the first two postoperative weeks on a rat intraperitoneal adhesion model induced by duodenum clamping trauma.MethodThe rat model of postoperative intraperitoneal adhesions was established in 48 male Wistar rats by laparotomy, followed by the duodenum clamping trauma. Rats were sacrificed respectively on 1st, 3rd, 5th, 7th and 14th day after the operation. The control rats were sacrificed immediately after the operation (0 day). Then the intraperitoneal adhesions were assessed macroscopically. Histopathology and immunohistochemistry were performed to evaluate the fibrosis, inflammatory responses, neovascularization, and cells infiltration in adhesion tissues. In addition, the changes of the mesothelium covering the surgical sites were examined by scanning electron microscopy.ResultsOur study revealed that duodenum clamping trauma induced by mosquito hemostat can result in significant postoperative intraperitoneal adhesions formation. The extent and tenacity of intraperitoneal adhesions reached their peaks on 3rd and 5th days, respectively. Histopathological examination showed that all rats developed inflammatory responses at the clamped sites of duodenum, which was most prominent on 1st day; the scores of fibrosis and vascular proliferation increased slowly from 3rd to 5th day. Myofibroblasts proliferated significantly in the adhesion tissues from 3rd day, which were examined by immunohistochemical method. And the mesothelium covering the surgical sites and the adhesion tissues healed on 7th day.ConclusionThis study suggests that clamping trauma to the duodenum can result in significant postoperative intraperitoneal adhesions formation, which represents an ideal rat model for intraperitoneal adhesions research and prevention. And myofibroblasts may play an important role in the forming process of intraperitoneal adhesions.
Highlights
The intraperitoneal adhesions are pathological bonds usually be-tween the omentum, viscera and abdominal wall [1]
Our study revealed that duodenum clamping trauma induced by mosquito hemostat can result in significant postoperative intraperitoneal adhesions formation
Myofibroblasts proliferated significantly in the adhesion tissues from 3rd day, which were examined by immunohistochemical method
Summary
The intraperitoneal adhesions are pathological bonds usually be-tween the omentum, viscera and abdominal wall [1]. The intraperitoneal adhesions always took shape within the first five to seven days after the injury to peritoneum [6]. It is the result of both insufficient fibrinolytic capacity and increased fibrin formation in response to an enhanced inflammatory status of the peritoneum [3]. Better understanding of the forming process and pathologic mechanism of intraperitoneal adhesions will contribute to the promotion of prevention measures. Results from animal studies investigating prevention or treatment of adhesions are limited, due to lack of consistency in existing animal models. In our present model, traumatizing the duodenum by clamping with a hemostat is the direct cause of intraperitoneal adhesions. The histological and morphological changes in the first two postoperative weeks were studied and the mechanisms were investigated
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