Mitomycin-C prevents reformation of intra-abdominal adhesions after adhesiolysis

Abstract

Background. Prevention of adhesions is central to surgical practice, because they cause significant morbidity. Inhibition of fibroblast proliferation is a way to prevent adhesions. Mitomycin-C (MMC) (Kyowa-Hakko-Kogyo Co, Ltd, Tokyo, Japan) is an alkylating agent that also inhibits fibroblast proliferation for up to a few weeks. We investigated the effect of MMC on the prevention of adhesion reformation. Methods. Adhesions were generated by brushing the cecum and parietal peritoneum in 60 female Wistar albino rats. Ten days later, during a second laparotomy, adhesions were graded. After adhesiolysis, rats were divided into 3 groups. Group 1 was intraperitoneally administered 5 mL of saline solution, whereas groups 2 and 3 were intraperitoneally administered 0.5 mg/kg MMC in 5 mL of saline solution. MMC solution in the abdomen was completely rinsed and aspirated after 5 minutes in group 2 and after 10 minutes in group 3. Then, all the rats were administered 5 mL of saline solution intraperitoneally. After 10 days, adhesions were graded again during a third laparotomy. Results. Both MMC groups had significantly lower adhesion scores compared with the control group (P <.001). No side effects from MMC were observed during the experiment. Conclusions. MMC was found to be very effective in preventing adhesion reformation. (Surgery 2002;131:81-4.)