Sıçan uterin horn modelinde enoksaparin ve rapamisinin adezyon oluşumuna etkilerinin karşılaştırılması

Abstract

Aim. Several studies have demonstrated that low molecular weight heparins (LMWHs) decreased postoperative adhesion formation. Also, a few studies have noted that immunosuppressive agent rapamycin decreased postoperative adhesion formation. In this experimental study, we aimed to investigate the effect of enoxaparin and rapamycin alone and in combination on the adhesion formation in a rat uterine horn model. Methods. Our study included 40 Wistar-Albino rats weighing between 200-250 g. Control and three study groups were formed including 10 rats. In sterile condition, we performed 3-cm midline incision of abdominal wall under general anesthesia. On the antimesenteric surface of both uterine horns, 8-10 unipolar electrocauterization were applied. Later these antimesenteric surfaces were sutured to abdominal sidewalls with 4.0 polydioxanone. In the control group, no therapy was applied after surgery and incision was closed according to general surgical rules. In the enoxaparin group, enoxaparin 50 U/kg was applied intraperitoneally for 14 days. In the rapamycin group, rapamycin 0.8 mg/kg was applied orally with feeding tube for 14 days. In the enoxaparin plus rapamycin group, enoxaparin 50 U/kg was applied intraperitoneally and rapamycin 0.8 mg/kg orally with the feeding tube for 14 days. The animals were sacrificed by lethal dose pentobarbital 14 days after surgery and a midline laparatomy was carried out and abdominal cavity was inspected for the presence of adhesion and adhesion samples were obtained for histopathological examination. Results. According to the findings of macroscopic and microscopic evaluation, the scores of adhesion severity were found comparable among the enoxaparin, rapamycin and enoxaparin plus rapamycin groups (p>0.05); however, the scores of adhesion extent and total adhesion scores were significantly lower in the drug groups compared to the control group (p 0.05). Conclusion. Enoxaparine and rapamycin prevent total adhesion similarly, however, this effect is considerable on the extent of adhesion rather than the severity of adhesion. Combination of enoxaparin and rapamycin did not show synergistic effect on adhesion formation.