Intra-peritoneal administration of Ecballium elaterium diminishes postoperative adhesions.

Mehmet Hanifi Okur,Serkan Arslan,Ulaş Alabalik,Mehmet Serif Arslan,Fethiye Canpolat,Atalay Şahin,Bahattin Aydogdu,İbrahim Kara,Selçuk Otcu

doi:10.1590/s0102-8650201400160003

Abstract

To evaluate the effects of Ecballium elaterium (EE), Elaterium officinarum, in postoperative intraperitoneal adhesions in rats. Thirty rats were divided into three groups and underwent midline laparotomy under 35 mg/kg ketamine and 5 mg/kg xylazine anaesthesia. In group 1 (n=10), the sham operation group, the abdominal walls were closed without any process. In group 2 (n=10), the control group, the antimesenteric border of the ceacum and the corresponding parietal peritoneum were abraded with dry sterile gauze. In group 3 (n=10), the EE group, 2.5 mg/kg dose of EE was administered as intraperitoneally to the rats after abrasion. All rats were sacrificed on postoperative day 15. Samples were obtained The adhesion score was significantly decreased in the EE group (p=0.001) in comparison with the control group. Microscopically, the EE and sham groups were significantly lower than that of the control group (p<0.001 and p=0.000, respectively). Furthermore, the measurement of tissue levels of hydroxyproline was significantly lower in the sham and EE groups compared to the control group (sham group: 47.6 ± 10.6, EE group: 62.9 ± 9.7, CONTROL GROUP: 84.2 ± 22.1 mg /L/g-tissue). The grade and severity of abdominal adhesion could be significantly reduced through administered Ecballium elaterium and therefore be a suitable anti-inflammatory agent for the prevention of postoperative peritoneal adhesion in the future.

Highlights

Anaesthesia and surgical proceduresPostoperative peritoneal adhesions (PPAs) are pathologic fibrotic bands formed between the omentum, intestinal loops, and abdominal wall or at any surface of the peritoneal cavity
The grade and severity of abdominal adhesion could be significantly reduced through administered Ecballium elaterium and be a suitable anti-inflammatory agent for the prevention of postoperative peritoneal adhesion in the future
The likelihood of intra-abdominal adhesion development has been reported as 67–93% after all laparotomies and 3% of all laparotomies are due to PPAs5,6

Summary

Introduction

Postoperative peritoneal adhesions (PPAs) are pathologic fibrotic bands formed between the omentum, intestinal loops, and abdominal wall or at any surface of the peritoneal cavity. The likelihood of intra-abdominal adhesion development has been reported as 67–93% after all laparotomies and 3% of all laparotomies are due to PPAs5,6. The pulp of Ecballium elaterium (EE), a herbaceous plant from the Cucurbitaceae family, is traditionally used for the treatment of sinusitis in Anatolian folk medicine. It has well-known hydragogue cathartic, antitumor, antimicrobial, and anti-inflammatory effects[8,9]. We planned to investigate the effects of EE in preventing PPA in an animal model

Methods

Results

Conclusion