Effect of intraperitoneal and systemic sirolimus administration on postoperative peritoneal adhesions in rats

Abstract

Purpose: Consequences and complications due to postsurgical adhesions remain to be substantially high. Perilous complications such as inadvertent enterotomy during reopening of abdomen or bowel obstruction may cause not only morbidity but also mortality. Immunosuppressive drugs seem to have a positive effect on postoperative adhesion prevention. Sirolimus is a carbocyclic, lactone-lactam macrolide antibiotic with immunosuppressive, antitumoral, and antifungal properties. Currently sirolimus has clinical usage in posttransplantation immunosuppression and in coronary and peripheral artery vascular stents on routine basis with a relatively low adverse effect profile. We aimed to define and compare systemic and intraperitoneal effect of sirolimus on postoperative peritoneal adhesions.
 Methods: Three groups of rats for intraperitoneal sirolimus, systemic sirolimus, and control group have been constituted. A peritoneal adhesion model created on each rat. On postoperative 7. day all rats were surgically explored and evaluated with a macroscopic adhesion scoring system. 
 Results: After macroscopic evaluation scores assessed, there were statistically significant difference between three groups (intraperitoneal sirolimus, oral-systemic sirolimus and control). There was statistically significant difference between intraperitoneal sirolimus and control groups. 
 Conclusion: This study showed that in a rat model intraperitoneal sirolimus administration has significant effect on postoperative adhesion prevention.