Intra-abdominal Adhesions In Rats Research Articles

Effect of intra-abdominal boric acid in the experimental adhesion model.

The continuous advancement in medical and surgical techniques has led to a rise in the frequency of abdominal operations, subsequently increasing the incidence of intra-abdominal adhesions. Over 90% of laparotomies result in postoperative intra-abdominal adhesions. This study investigates the effect of a 5% boric acid solution on the development of intra-abdominal adhesions in rats, using an adhesion model. This study was conducted with two groups: a control group, in which the adhesion model was applied without any treatment, and a boric acid group, which was treated with a 5% boric acid solution. Each group comprised 16 rats. On the 14th postoperative day, the rats were sacrificed, re-explored, and the developed adhesions were evaluated both macroscopically and microscopically. The data from macroscopic and microscopic scoring were analyzed using the Mann-Whitney U test in the IBM Statistical Package for the Social Sciences (SPSS) Statistics 24 program. A p-value of less than 0.05 was considered statistically significant. This research was supported by the Manisa Celal Bayar University Scientific Research Projects Commission. A statistically significant difference was observed between the boric acid-treated group and the control group, with the boric acid group showing a significant decrease in adhesion development both macroscopically and microscopically (p<0.05). In the future, boron could play a significant role in reducing and preventing intra-abdominal adhesions after surgery. This investigation could pave the way for further research into the mechanism by which boric acid prevents the development of intra-abdominal adhesions. Moreover, it is imperative to explore the potential side effects of intra-abdominal boron application at the optimum concentration of the solution.

Topical Application of High-Dose Mesna Prevents Adhesion Formation: An Experimental Animal Study

BackgroundAdhesion formation is a common complication of abdominal surgeries. Mesna is a drug with fibrinolytic properties which has been used in surgical field to facilitate tissue dissection. The aim of this experimental animal study was to investigate the effect of mesna on prevention of intra-abdominal adhesion in rats. Materials and methodsTwenty-eight Wistar albino rats were used in the study. To create abdominal adhesion, cecum was abraded in all rats. No additional surgical procedure was performed other than adhesion in group 1 (only adhesion). In the other groups, rats were treated topically by administering 0.9% saline (group 2), 40 mg/kg mesna (group 3), and 400 mg/kg mesna (group 4). All rats were sacrificed on postoperative 21st day. Histopathological and macroscopic evaluations of adhesion formation were performed. ResultsQuantity of adhesion scores (P = 0.022), severity of adhesion scores (P = 0.041), total adhesion scores (P = 0.023), and histopathological adhesion grading scores (P < 0.001) were reduced by 400 mg/kg mesna. ConclusionsThis is the first study for mesna on prevention of abdominal adhesion formation in rats. We concluded that dose-dependent reduction of adhesion was achieved by mesna. With future studies, topical administration of mesna during open abdominal surgeries may be used to prevent adhesion formation.

Effects of vitamin E, methylprednisolone and nedocromil sodium on healing of rats with experimentally created intraabdominal adhesions

IntroductionIntraabdominal adhesions are a condition that can occur after many surgical procedures and may cause complications in a spectrum ranging from simple abdominal pain to ileus. For years, efforts have been made to prevent this complication. In this experimental study, the effects of methylprednisolone, vitamin E and nedocromil sodium on the improvement of intraabdominal adhesions in rats were investigated.Material and methodsTwenty Wistar Albino rats weighing 280 to 330 g were divided into four equal groups. 5 ml of 0.9% NaCl was given to the control group, 5 ml of methylprednisolone was given to group 2, 5 ml of vitamin E to group 3 and 5 ml of nedocromil sodium to group 4 were given intraabdominally. On the 14th postoperative day, all rats were sacrificed and re-laparotomy was performed. Intraabdominal adhesions were scored according to the Nair classification.ResultsWhen the groups were compared dyadically, the difference between group 1 and group 2 was found to be statistically significant (p = 0.011). The difference between group 1 and group 3 was statistically significant (p = 0.011). The difference between group 1 and group 4 was statistically significant (p = 0.007). There was no statistically significant difference between group 2 and group 3, and group 2 and group 4, and group 3 and group 4 (p &lt; 0.05).ConclusionsAs a result, methylprednisolone, vitamin E and nedocromil sodium have been shown to have a healing effect on adhesions.

Effect of xanthan gum on the prevention of intra-abdominal adhesion in rats

Postoperative adhesions remain a significant concern following abdominal surgery. Polymer barriers are widely used to prevent adhesions, although none have been able to completely prevent adhesions in all situations. Therefore, it is still crucial to develop new products that are effective in a variety of surgical applications. In this study, XG with different concentrations (0.5%–2%, w/v) and molecular weight (Mw) (2.5 × 106 Da–6.9 × 106 Da) were prepared to estimate their potential application as an injectable tissue adhesion barrier. The results showed that XG exerts an anti-adhesion effect in the rat abdominal cavity. For XG with Mw of 5.5 × 106 Da, a 1% or greater concentration was needed to form a gel with required effect as an anti-adhesion agent. The 1% XG gel with high Mw (6.9 × 106 Da) was more effective for the prevention of adhesions compared to a commercially available gel (1.2% sodium hyaluronate). Histological and cytotoxic evaluation demonstrated that XG gel showed no side effect during wound healing, and had no in vitro cytotoxicity to L929 cells. Moreover, rheological analysis was conducted to correlate the anti-adhesion effect with the rheological behavior of XG gels. This investigation suggests that XG has good potential value in intra-abdominal adhesion prevention.

Pharmacological Mobilization and Recruitment of Endogenous Stem Cells Prevents Postsurgical Intra-Abdominal Adhesion in Rats

Background: Postsurgical adhesions are a very common complication causing various symptoms from pain to bowel obstruction. We have developed a stem cell mobilizing strategy that enables long-term liver and kidney allograft survival without sustained immunosuppression in animals using a combination of AMD3100 and low-dose FK506 (AF). Serendipitously we have noted a subjective decrease in adhesion formation in animals with AF combination treatment. The purpose of this study was to evaluate the effect of a new stem cell mobilizing strategy on preventing postsurgical adhesion formation in rats. Methods: Abdominal adhesions were induced by creating suture knots on the parietal peritoneum in Lewis rats. Animals were divided randomly into four experimental groups and received subcutaneous injections of saline, single drug or AF combination every other day for 10 days. On postoperative day 14, animals were euthanized and the severity of adhesions were evaluated and scored blindly by five individual surgeons. Results: Most animals treated with saline or single drug exhibited severe peritoneal adhesions around sites of suture knots. AF combination significantly reduced the formation of peritoneal adhesions, 64% animals (7/11) showed few or mild adhesion and no animal showed severe peritoneal adhesions. Searching for mechanisms, we found AF treatment dramatically increased SDF-1 expressing cells, HGF expressing Ym1 M2 macrophages and CD133 stem cells in the injury sites of peritoneal surface at day 5 post-operation. Conclusion: Pharmacological mobilization and recruitment of endogenous stem cells using AF combination significantly reduced postsurgical intra-abdominal adhesions in rats. These findings suggest a novel therapeutic approach to preventing postsurgical adhesions in patients undergoing abdominal or pelvic surgery. Funding Statement: This work was supported by a start-up fund from the surgical department at Johns Hopkins University. Declaration of Interests: None of the authors has a financial interest in any of the products, or drugs mentioned in this manuscript. Ethics Approval Statement: Animals were maintained in a pathogen-free facility of Johns Hopkins University School of Medicine and all animal experiments were performed in accordance with the United States National Institutes of Health (NIH) guidance. All animal protocols were reviewed and approved by the Johns Hopkins University Animal Care and Use Committee.

Gallic Acid Attenuates Postoperative Intra-Abdominal Adhesion by Inhibiting Inflammatory Reaction in a Rat Model.

BackgroundIntra-abdominal adhesion is one of the most common complications after abdominal surgery. The efficacy of current treatments for intra-abdominal adhesion is unsatisfactory. In this study, we investigated the effect of gallic acid on the prevention and treatment of intra-abdominal adhesions after abdominal surgery using an intra-abdominal adhesion rat model.Material/MethodsThe experimental rats were randomly divided into the sham operation group, the control group, the chitosan group, and 3 gallic acid groups of different concentrations. All rats except those in the sham operation group received cecal abrasion to induce adhesion. From the first postoperative day, the rats in the gallic acid groups were administered different concentrations of gallic acid in a 2-ml gavage daily. All rats were sacrificed on postoperative day 7, and the degree of intra-abdominal adhesion was evaluated by the naked eye. The amount of collagen deposited between the injured peritoneal tissues was assessed by Sirius red staining. Serum levels of interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and transforming growth factor-β (TGF-β) were measured by ELISA. Western blot was used to detect the level of NF-κB phosphorylation in the injured peritoneal or adhesion tissues of the rats.ResultsCompared with the control group, the scores of intra-abdominal adhesions in the rats treated with larger doses of gallic acid were significantly decreased, and the degree of inflammation and fibrosis was also significantly decreased. Gallic acid significantly reduced IL-6, TNF-α, and TGF-β1 serum levels. NF-κB phosphorylation in the higher gallic acid groups was significantly reduced.ConclusionsGallic acid inhibits the formation of postoperative intra-abdominal adhesions in rats by inhibiting the inflammatory reaction and fibrogenesis. Gallic acid is a promising drug for preventing intra-abdominal adhesions.

Su1228 - Pharmacological Mobilization of Endogenous Stem Cells Prevents Postsurgical Intra-Abdominal Adhesion in Rats

Su1228 - Pharmacological Mobilization of Endogenous Stem Cells Prevents Postsurgical Intra-Abdominal Adhesion in Rats

Evaluation of botulinum toxin type A effectiveness in preventing postoperative intraperitoneal adhesions.

PurposePostoperative intraperitoneal adhesions (PIAs) are one of the most important problems surgeons have to face after laparotomies. In this study, we aimed to evaluate the effectiveness of local application of botulinum toxin type A (BoNT-A) in various dosages on the prevention of intra-abdominal adhesions in rats with experimental intra-abdominal adhesions.MethodsForty Wistar Albino female rats were randomly separated into 4 groups. The 4 groups were determined as follows: Control (group 1, n = 10); Sham (group 2, n = 10); 10-µg/kg low-dose BoNT-A (group 3, n = 10) and 30-µg/kg high-dose BoNT-A (group 4, n = 10). Subserosal injuries were created on the caecum of all rats. Laparotomy was performed on the fifth day. Adhesion scores, histopathological examination, and E-cadherin expression levels were evaluated.ResultsGeneral adhesion scores for groups 1 and 2 were determined to be significantly high when compared to group 4 (P < 0.001). A significant difference was also determined between groups 3 and 4 in terms of general adhesion scores (P < 0.05). In pair comparisons, a significant decrease in high-dose BoNT-A group (group 4) when compared to groups 1 and 2 in terms of neovascularization, fibroblast density, collagen deposition and inflammatory cell count was determined (P < 0.05).ConclusionA significant decrease was observed only in postoperative PIAs in the high-dose BoNT-A group between all 4 rat-groups with experimentally created postoperative PIAs. In this study, high-dose BoNT-A is determined to be an effective agent in preventing postoperative PIAs.

The potential efficacy of Survanta (r) and Seprafilm (r) on preventing intra-abdominal adhesions in rats.

To investigate the potential efficacy of beractant (Survanta(r)) and Seprafilm(r) on the prevention of postoperative adhesions. Forty Wistar-albino female rats were used. The rats were randomly allocated into four groups of 10 rats each as control group (CG), beractant group (BG), Seprafilm(r) group (SG), and combined group (COG). All rats underwent cecal abrasion via midline laparotomy. Before abdominal closure, isotonic saline, beractant, Seprafilm, and combined agents were intraperitoneally administered. Adhesions were classified macroscopically with Canbaz Scoring System on postoperative day 10. Ceacum was resected for histopathological assessment. Macroscopic adhesion scores were significantly lower in BG, SG, and COG than CG (p<0.05); (45%, 15%, 25%, and 15%; respectively). Histopathological assessment revealed a reduced inflammation and fibrosis score in the study groups than CG (p<0.05). In BG, adhesion development, inflammation and fibrosis scores were lower than SG; however, it was not statistically significant. Intra-abdominal application of beractant is significantly effective for the prevention of adhesion formation with no adverse effect by covering the whole peritoneal mesothelium with excellent gliding properties in a rat model. The combination of both agents is also effective in reducing adhesion formation, however, not superior to single beractant application.

Preventive Effects of the Intestine Function Recovery Decoction, a Traditional Chinese Medicine, on Postoperative Intra-Abdominal Adhesion Formation in a Rat Model.

The intestine function recovery decoction (IFRD) is a traditional Chinese medicine that has been used for the treatment of adhesive intestinal obstruction. In this study, the preventative effects and probable mechanism of the IFRD were investigated in a rat model. We randomly assigned rats to five groups: normal, model, control, low dose IFRD, and high dose IFRD. In the animal model, the caecum wall and parietal peritoneum were abraded to induce intra-abdominal adhesion formation. Seven days after surgery, adhesion scores were assessed using a visual scoring system, and histopathological samples were examined. The levels of serum interleukin-6 (IL-6) and transforming growth factor beta-1 (TGF-β1) were analysed by an enzyme-linked immunosorbent assay (ELISA). The results showed that a high dose of IFRD reduced the grade of intra-abdominal adhesion in rats. Furthermore, the grades of inflammation, fibrosis, and neovascularization in the high dose IFRD group were significantly lower than those in the control group. The results indicate that the IFRD can prevent intra-abdominal adhesion formation in a rat model. These data suggest that the IFRD may be an effective antiadhesion agent.

Evaluation of ligustrazine on the prevention of experimentally induced abdominal adhesions in rats

ObjectiveTo determine the effects of ligustrazine on the prevention of postoperative intra-abdominal adhesions in rats. Materials and methodsAbdominal adhesions were induced by scraping the cecum of rats. Various dosages of ligustrazine were administered for 10 days after surgery. Grades of abdominal adhesions were ranked by macroscopic observation on the 11th day after surgery. Meanwhile, the levels of IL-1β, IL-6, TNF-a in blood serum and TGF-β1, CTGF in peritoneal fluid were determined by ELISA assay. In the cell experiment, the secretion of FN and CTGF undergoing stimulation with TGF β1 in the culture fluid of rat peritoneal mesothelial cells (RPMC) were measured by ELISA assay. And the expression of Smad7 and p-smad 2/3 in RPMC were evaluated by western blot analysis. ResultsLigustrazine remarkably alleviated the adhesions at the dose of 30 mg/kg and 60 mg/kg compared with the non-treated surgery group (p < 0.05). Ligustrazine decreased the levels of IL-1β, IL-6, TNF-α in blood serum and the expression of TGF-β1, CTGF in the peritoneal fluid in dose-dependent manner. In the cell experiment, ligustrazine markedly attenuated TGF-β1 induced upregulation of FN and CTGF in RPMC. Meanwhile, ligustrazine significantly inhibited the expression of pSmad 2/3 and increased the level of Smad7 in the RPMC. ConclusionsLigustrazine is a potent postoperative adhesion preventer by inhibiting inflammation and regulating the TGF/Smad signaling pathway.

Bioactive components and preventive effect of green tea (Camellia sinensis) extract on post-laparotomy intra-abdominal adhesion in rats

BackgroundAdhesion formation is an important complication of abdomino-pelvic surgery. Green tea (Camellia sinensis) has anti-oxidant and anti-inflammatory effects which prevent production and accumulation of collagen and, thus, may reduce adhesion formation. The present study examined the effect of green tea alcoholic extract on intra-abdominal adhesion formation. Total phenolic, flavonoid and flavonol contents as well as anti-oxidant activity were also evaluated. MethodsThirty healthy male Wistar rats were randomly assigned to two equal groups of green tea (A) and distilled water (B). After anesthesia, the abdominal wall was opened and three shallow longitudinal and transverse incisions of 2 cm in length were made on the right side of the peritoneum by scalpel blade. A 2 × 2 cm square of the left abdominal wall peritoneum was removed by surgical scissors. Green tea extract or distilled water was introduced into the abdominal cavity of each rat. The rats were sacrificed two weeks post-laparotomy and adhesion bands were scored according to severity, extent and appearance. Fibrosis and inflammation were also scored via histopathological examination. ResultsThere was a significant difference in mean adhesion scores between the green tea and distilled water groups (3.2 ± 3.503 and 7.33 ± 0.51, respectively) (p = 0.001). In terms of fibrosis (p = 0.002) and inflammation (p = 0.003) a statistically significant difference was also seen between the two groups following histopathological examination. ConclusionGreen tea extract reduces intra-peritoneal adhesions in an animal model.

Effect of Caffeic Acid Phenethyl Ester on Intra-Abdominal Adhesion in Rats

Background: To determine the impact of caffeic acid phenethyl ester (CAPE) on abdominal adhesion formation after laparotomy. Methods: Forty female rats were allocated into four distinct groups on which laparotomy alone; laparotomy with traumatization of the uterine horns; laparotomy, traumatization of the uterine horns and intraperitoneal irrigation with saline, and laparotomy, traumatization of the uterine horns and intraperitoneal irrigation with CAPE were performed. After sacrifying the animals on the 14th postoperative day, histopathological examination and biochemical analysis were conducted to evaluate the formation of abdominal adhesions and antioxidant status. Results: In the CAPE group, total adhesion scores were significantly lower than in the control and saline groups. The CAPE group displayed less inflammation, giant cell formation, fibrosis and fibroblastic activity than the control group. On the other hand, the control group displayed higher total adhesion scores. Conclusion: The results of this study indicate that the administration of CAPE may have beneficial effects for the prevention of abdominal adhesion formation after laparotomy. Further clinical studies are mandatory to explore the actual therapeutic potential of CAPE.

The Effect of Postoperative Hyperbaric Oxygen Treatment on Intra-Abdominal Adhesions in Rats

Abdominal adhesions, whether caused by peritoneal trauma, radiation, infection, or a congenital condition, are associated with a wide range of complications. These complications include chronic abdominal or pelvic pain, infertility, and adhesive small bowel obstruction. Such adhesions render re-operation difficult, with attendant risks of inadvertent enterostomy and increased operation time. The purpose of this study was to investigate the potential of hyperbaric oxygen (HBO) therapy in the prevention of abdominal adhesions in an experimental animal study. A laparotomy was performed on Wistar rats to induce the formation of adhesions on the cecum and the intra-abdominal area (1 × 2 cm). A superficial layer of the underlying muscle from the right abdominal wall was also shaved and prepared for aseptic surgery. The rats were divided into four groups according to the duration of HBO therapy; five additional groups were designated according to the conditions of HBO therapy. When the rats were evaluated according to adhesion area and grade, a statistically significant difference was observed between the control and HBO treatment groups (p < 0.005). Results from this study suggest that HBO treatment could reduce adhesion formation; and further suggest that HBO therapy may have therapeutic potential in the treatment of postoperative peritoneal adhesion.

Efficacy of vitamin E and selenium for the prevention of intra-abdominal adhesions in rats: uterine horn models

OBJECTIVE:This study compares the efficacies of vitamin E and selenium, both individually and in combination, for the prevention of postoperative intra-abdominal adhesions in rats.METHODS:Forty-seven female rats were divided into five groups. The sham animals (S group, n = 7) were given only laparotomies and intraperitoneally received 0.9% NaCl (2 ml). In the 40 other rats, abrasions of the left uterine horn were performed, followed by intraperitoneal administration of either 2 ml 0.9% NaCl (C group), 10 mg vitamin E (vitamin E group), 0.2 mg/kg selenium (Se group) or 10 mg vitamin E with 0.2 mg/kg selenium (vitamin E + Se group), with 10 animals in each treatment group.RESULTS:Adhesion formation was significantly reduced in animals in the Se and vitamin E + Se groups (p<0.05). Tissue catalase and glutathione peroxidase activities did not significantly differ between the groups. However, catalase and glutathione peroxidase activities and reduced glutathione levels were slightly increased in the vitamin E, Se and vitamin E + Se groups. In the vitamin E group, malondialdehyde concentrations were significantly lower than in the C group (p<0.05), but no significant differences were present among the S, C, Se and vitamin E + Se groups. Levels of nitric oxide were significantly higher in the C group than in the other groups (p<0.01).CONCLUSION:Intraperitoneal administration of selenium or combined vitamin E and selenium appears to be effective in preventing intra-abdominal adhesion formation in rat models through the reduction of lipid peroxidation products.

The effectiveness of local anesthetics in preventing postoperative adhesions in rat models

Intra-abdominal adhesions are fibrous bands that develop after abdominal surgery or inflammation and cause significant surgical morbidity and mortality. In this study, the effectiveness of lidocaine, prilocaine and bupivacaine in preventing experimental intra-abdominal adhesions in rats was studied. After obtaining the approval of our local institutional review board, 50 female Wistar-Albino rats weighing 250-320g underwent laparotomy via a standard 5-cm midline incision under intramuscular anesthesia with ketamine (40mg/kg) and xylazine (10mg/kg). The cecal serosa and adjacent abdominal wall were superficially injured using sterile gauze. The laparotomy incision was closed after irrigation of the peritoneal cavity with the following: 5ml saline in Group II, (the sham group), 7mg/kg prilocaine in Group III, 3mg/kg lidocaine in Group IV or 2mg/kg bupivacaine in Group V. No irrigation was performed in Group I rats (the control group). After laparotomy closure, all rats were allowed to wake spontaneously. Two weeks after the initial experimental procedure, all rats underwent a second laparotomy, and adhesions were scored using the Linsky scale. The adhesion quantity and quality were comparable among all groups (P>0.05); however, adhesion severity scores were significantly lower in the prilocaine and bupivacaine groups vs. the other groups (P<0.05). Prilocaine and bupivacaine were found to decrease the severity of intra-peritoneal adhesions.

Comparison of the Two Types of Bioresorbable Barriers to Prevent Intra-Abdominal Adhesions in Rats

PurposeThe aim of this study was to evaluate the efficacy of two absorbable film barriers, polylactic acid and sodium hyaluronate–carboxymethyl cellulose, in preventing postoperative intra-abdominal adhesions, inflammation, and fibrosis in an animal model. MethodsForty Wistar albino rats were grouped as polylactic acid, sodium hyaluronate–carboxymethyl cellulose, and control. All rats underwent laparotomy with subsequent cecal wall abrasion and abdominal wall injury. The two treatment groups received polylactic acid or sodium hyaluronate–carboxymethyl cellulose film barriers, while control group received nothing. On postoperative day 21, three observers graded the intra-abdominal adhesions and resected specimens. Fibrosis, inflammation, and adhesions were graded using quantitative scoring systems. ResultsWhen compared to control group, polylactic acid group showed significantly less inflammation and adhesion (p < 0.005), while there was no significant difference for fibrosis. Sodium hyaluronate–carboxymethyl cellulose group has showed significantly less adhesions (p < 0.005), but there were no significant differences among fibrosis and inflammation when compared to control group. There were no significant differences between polylactic acid and sodium hyaluronate–carboxymethyl cellulose groups on adhesion formation, inflammation, or fibrosis. ConclusionsPlacement of polylactic acid or sodium hyaluronate–carboxymethyl cellulose film barriers between injured surfaces is associated with a significantly reduced rate of postoperative adhesions. No superiority was detected between two barriers.

An FDA Approved Neurokinin-1 Receptor Antagonist is Effective in Reducing Intraabdominal Adhesions when Administered Intraperitoneally, But Not Orally

IntroductionPostoperative adhesions pose a continued healthcare problem. We previously demonstrated that intraperitoneal (IP) administration of a neurokinin-1 receptor antagonist (NK-1RA) at surgery reduces intraabdominal adhesions in rats. The NK-1RA aprepitant (Emend™, Merck) is clinically approved for preventing postoperative nausea and vomiting; however, its effects on adhesion formation are unknown. Thus, we determined the effects of IP and oral administration of aprepitant on adhesion formation in a rat model. MethodsAdhesions were surgically induced in rats that were randomized to receive either one or five oral preoperative doses or a single intraoperative IP dose of aprepitant (50 mg/kg). Adhesions were scored at 7 days. In similar experiments using IP dosing, animals were sacrificed at 24 h and peritoneal fluid, and tissue were collected to assess fibrinolytic activity and tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) mRNA levels, respectively. ResultsIP aprepitant reduced adhesion formation by 33% (p < 0.05) compared with controls while oral aprepitant had no effect. Compared to controls IP aprepitant reduced tPA activity by 55% (p < 0.05), increased PAI-1 mRNA levels by 140% (p < 0.05), and had no affect on tPA mRNA levels. ConclusionThese data suggest that aprepitant maybe a useful pharmacologic agent for reducing adhesion formation clinically.

Prevention of intra-abdominal adhesions by using Seprafilm® in rats undergoing bowel resection and radiation therapy

Objective Intra-abdominal adhesions are an important surgical problem. Colorectal operations are a major cause of adhesive obstruction. Radiation therapy (RT) is frequently used as an adjuvant therapy to surgery for rectal cancer, though its value for colon carcinoma remains unclear. Peritoneal injuries including the surgical trauma, tissue ischaemia as well as RT are associated with peritoneal fibrinolytic activity. A sodium hyaluronate and carboxymethylcellulose bioresorbable membrane (Seprafilm®) has been used to reduce intra-abdominal adhesion formation. We have investigated the effect of Seprafilm® on intra-abdominal adhesion in rats receiving RT after the resection of the left colon. Materials and methods Thirty-two male Wistar rats were divided into two groups: group 1 (n=16), control (colon resection, no Seprafilm®); group 2 (n=16), study group (colon resection and Seprafilm®). All the rats received 50 Gy RT after left colon resection. Intra-abdominal adhesions were evaluated by grading and measurement of tissue-type plasminogen activator (tPA) as a tissue adhesion marker in peritoneal samples from the rats. tPA was determined using a commercially available ELISA kit. Results The levels of tPA were significantly increased in group 2 rats compared with those in the control group (P=0.0276). It was also seen that adhesions in the rats receiving Seprafilm® were significantly less severe than those in the control group. Conclusion Our findings suggest that the intraperitoneal administration of Seprafilm® reduced the frequency and strength of adhesions.

The effect of piroxicam on the formation of postoperative, intraabdominal adhesion in rats

Background/Aims:Peritoneal adhesions are fibrous bands of tissues formed between organs that are normally separated and/or between organs and the internal body wall after peritoneal injury. Antiinflammatory agents were used to reduce the initial inflammatory response to tissue injury and, hence, the subsequent formation of adhesion. The aim of this study was to investigate the effect of intraperitoneal instillation of piroxicam on intraperitoneal adhesions.Methods:Eighty Wistar rats were subjected to standardized lesion by using the scraping model and were randomly divided into four groups. Group I (control) received no treatment; groups II, III, and IV received 10-12.5 mL of 0.05, 0.1, and 0.2 mg/mL piroxicam solution, respectively, after surgery. On the 14th postoperative day, the adhesion intensity score, inflammatory cell reaction, and the number of adhesion bands were determined.Results:There were no rats with grade 0 adhesions in the control group. There were 10 rats (50%) with grade 2 and eight rats (40%) with grade 3 adhesions. The adhesion intensity (P < 0.0001) and the number of adhesion bands (P < 0.001) were significantly lower in groups III and IV. No significant difference was observed in the adhesion intensity or the number of adhesion bands between groups I and II.Conclusions:Intraperitoneal instillation of piroxicam solution might be useful for preventing peritoneal adhesions.