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Reduction of postsurgical adhesions in a rat model: a comparative study.

Irkorucu O, Ferahköşe Z, Memiş L, Ekinci O, Akin M - Clinics (Sao Paulo) (2009)

Bottom Line: In this study, we compared the possible individual effects of phosphatidylcholine (PC), Seprafilm II, and tissue plasminogen activator (t-PA) and the combined effects of phosphatidylcholine and t-PA on postoperative adhesion formation in a rat surgical model.The t-PA and phosphatidylcholine combination was most effective in reducing adhesion formation.On the other hand, usage of t-PA alone or in combination may increase risk of bleeding.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Zonguldak Karaelmas University Medical School, Zonguldak, Turkey. oktaytip@yahoo.com

ABSTRACT

Background: Adhesion formation after peritoneal surgery is a major cause of postoperative bowel obstruction, infertility, and chronic pelvic pain. In this study, we compared the possible individual effects of phosphatidylcholine (PC), Seprafilm II, and tissue plasminogen activator (t-PA) and the combined effects of phosphatidylcholine and t-PA on postoperative adhesion formation in a rat surgical model.

Materials and methods: A total of 50 Wistar male rats underwent median laparotomy and standardized abrasion of the visceral and parietal peritoneum. phosphatidylcholine, Seprafilm II, and t-PA alone and phosphatidylcholine and t-PA in combination were applied intraperitoneally at the end of the surgical procedure. Seven days after surgery, a relaparotomy was performed for adhesion grading and histopathological examination.

Results: A comparison of adhesion stages demonstrated a significant difference between the control group and the study groups (p<0.001). The adhesion grade of the combined treatment group was statistically different from that of the other groups (p<0.05). In the t-PA group and the combined group, six and two rats, respectively, developed hematomas locally on the cecum.

Conclusions: PC, t-PA, and Seprafilm II used individually reduced the adhesion grade. The t-PA and phosphatidylcholine combination was most effective in reducing adhesion formation. On the other hand, usage of t-PA alone or in combination may increase risk of bleeding. More detailed studies are needed, and future studies on the efficacy of a material for decreasing adhesion formation should include a comparison of several control materials in the same model.

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The appearance of local hematoma on the cecum in Group 4 (t-PA group)
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f1-12-br-0169: The appearance of local hematoma on the cecum in Group 4 (t-PA group)

Mentions: Based on these findings, it was concluded that all three products significantly reduced peritoneal adhesion development rate and adhesion grades. In Groups 4 (t-PA alone) and 5 (t-PA combined with PC), six and two rats, respectively, developed local hematomas on the cecum (Figure 1). Fifty percent of the adhesions in Group 2 (Seprafilm group) developed in the uncovered areas in the abdomen (n=3) (Figure 2).


Reduction of postsurgical adhesions in a rat model: a comparative study.

Irkorucu O, Ferahköşe Z, Memiş L, Ekinci O, Akin M - Clinics (Sao Paulo) (2009)

The appearance of local hematoma on the cecum in Group 4 (t-PA group)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2666474&req=5

f1-12-br-0169: The appearance of local hematoma on the cecum in Group 4 (t-PA group)
Mentions: Based on these findings, it was concluded that all three products significantly reduced peritoneal adhesion development rate and adhesion grades. In Groups 4 (t-PA alone) and 5 (t-PA combined with PC), six and two rats, respectively, developed local hematomas on the cecum (Figure 1). Fifty percent of the adhesions in Group 2 (Seprafilm group) developed in the uncovered areas in the abdomen (n=3) (Figure 2).

Bottom Line: In this study, we compared the possible individual effects of phosphatidylcholine (PC), Seprafilm II, and tissue plasminogen activator (t-PA) and the combined effects of phosphatidylcholine and t-PA on postoperative adhesion formation in a rat surgical model.The t-PA and phosphatidylcholine combination was most effective in reducing adhesion formation.On the other hand, usage of t-PA alone or in combination may increase risk of bleeding.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Zonguldak Karaelmas University Medical School, Zonguldak, Turkey. oktaytip@yahoo.com

ABSTRACT

Background: Adhesion formation after peritoneal surgery is a major cause of postoperative bowel obstruction, infertility, and chronic pelvic pain. In this study, we compared the possible individual effects of phosphatidylcholine (PC), Seprafilm II, and tissue plasminogen activator (t-PA) and the combined effects of phosphatidylcholine and t-PA on postoperative adhesion formation in a rat surgical model.

Materials and methods: A total of 50 Wistar male rats underwent median laparotomy and standardized abrasion of the visceral and parietal peritoneum. phosphatidylcholine, Seprafilm II, and t-PA alone and phosphatidylcholine and t-PA in combination were applied intraperitoneally at the end of the surgical procedure. Seven days after surgery, a relaparotomy was performed for adhesion grading and histopathological examination.

Results: A comparison of adhesion stages demonstrated a significant difference between the control group and the study groups (p<0.001). The adhesion grade of the combined treatment group was statistically different from that of the other groups (p<0.05). In the t-PA group and the combined group, six and two rats, respectively, developed hematomas locally on the cecum.

Conclusions: PC, t-PA, and Seprafilm II used individually reduced the adhesion grade. The t-PA and phosphatidylcholine combination was most effective in reducing adhesion formation. On the other hand, usage of t-PA alone or in combination may increase risk of bleeding. More detailed studies are needed, and future studies on the efficacy of a material for decreasing adhesion formation should include a comparison of several control materials in the same model.

Show MeSH
Related in: MedlinePlus