1
|
Park J, Kang H, Choi YS, Suh SW, Hong SA, Choi GJ, Sim WJ. Prevention of Intra-Abdominal Adhesions Using the Combination of Mediclore® and a Statin. Eur Surg Res 2021; 63:123-131. [PMID: 34864732 DOI: 10.1159/000519708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/17/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE This study investigated the antiadhesive effects of Mediclore®, rosuvastatin, and a combination of Mediclore and rosuvastatin in a rat adhesion model. METHODS The adhesion models (a total of 58 adult male rats) were divided into 4 groups. The control group (group C) received no special materials except for a saline. The experimental groups were treated with 5 mL of Mediclore (group M), rosuvastatin (group R), or rosuvastatin and Mediclore (group RM), and these materials were intraperitoneally placed under the incision. At postoperative day 14, the rats underwent re-laparotomy and adhesiolysis. Three investigators blinded to group assignment scored the extent of adhesion formation, the numbers of remote adhesions, and the extent of acute/chronic inflammation, fibrosis, edema, and congestion on resected specimens via histologic examination. RESULTS The macroscopic adhesion score in group RM (7.27 ± 3.51) was significantly lower than those in groups C (13.36 ± 2.24) and R (11.71 ± 1.98); group M (9.13 ± 4.09) had a significantly lower adhesion score than group C. The number of remote adhesions was significantly lower in groups R and RM than in group C. The acute inflammation score, chronic inflammation score, and fibrosis score in group RM; the acute inflammation score in group R; and the fibrosis score in group M were significantly lower than those in group C. CONCLUSION The intraperitoneal application of Mediclore and a combination of Mediclore and rosuvastatin effectively reduced postoperative adhesions.
Collapse
Affiliation(s)
- Jesung Park
- Department of Surgery, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Hyun Kang
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Yoo Shin Choi
- Department of Surgery, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Suk-Won Suh
- Department of Surgery, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Soon Auck Hong
- Department of Pathology, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Geun Joo Choi
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Woo Jung Sim
- Department of Surgery, Chung-Ang University Healthcare System Hyundae Hospital, Seoul, Republic of Korea
| |
Collapse
|
2
|
Moreira J, Vale AC, Alves NM. Spin-coated freestanding films for biomedical applications. J Mater Chem B 2021; 9:3778-3799. [PMID: 33876170 DOI: 10.1039/d1tb00233c] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Spin-coating is a widely employed technique for the fabrication of thin-film coatings over large areas with smooth and homogeneous surfaces. In recent years, research has extended the scope of spin-coating by developing methods involving the interface of the substrate and the deposited solution to obtain self-supported films, also called freestanding films. Thereby, such structures have been developed for a wide range of areas. Biomedical applications of spin-coated freestanding films include wound dressings, drug delivery, and biosensing. This review will discuss the fundamental physical and chemical processes governing the conventional spin-coating as well as the techniques to obtain freestanding films. Furthermore, developments within this field with a primary focus on tissue engineering applications will be reviewed.
Collapse
Affiliation(s)
- Joana Moreira
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal. and ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - A Catarina Vale
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal. and ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Natália M Alves
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal. and ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| |
Collapse
|
3
|
Azadi H, Davoodabadi A, Akbari H, Benafsheh HR, Norroddini M, Hajian A. Effect of pimecrolimus on postoperative peritoneal adhesions in rat: An experimental study. INTERNATIONAL JOURNAL OF SURGERY OPEN 2020. [DOI: 10.1016/j.ijso.2020.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
4
|
Choi GJ, Park HK, Kim DS, Lee D, Kang H. Effect of statins on experimental postoperative adhesion: a systematic review and meta-analysis. Sci Rep 2018; 8:14754. [PMID: 30283040 PMCID: PMC6170439 DOI: 10.1038/s41598-018-33145-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 09/24/2018] [Indexed: 12/14/2022] Open
Abstract
Adhesion is a significant concern after surgery. Many researchers studied the anti-adhesive effect of statin, of which results were inconsistent. Thus, we purposed to perform a systematic review and meta-analysis to evaluate the effect of statins on postoperative adhesion in an experimental study. A comprehensive search was conducted using MEDLINE, EMBASE, and Google Scholar to identify animal studies that investigated the postoperative anti-adhesive effect of statins applied at the surgical area. Primary outcome measure was gross adhesion score. Secondary outcomes included microscopic adhesion score and tissue plasminogen activator (t-PA) activity. Totally, 298 rats from 9 animal studies (172 rats received statin therapy and 126 rats received placebo or no treatment) were included in the final analysis. The combined results showed that gross and microscopic adhesion scores were significantly lower in the statin group in comparison to the control group (standardized mean difference [SMD] = 1.65, 95% confidence interval [CI]: 1.02 to 2.28, Pchi2 < 0.001, I2 = 77.9%; SMD = 1.90, 95% CI: 1.10 to 2.79, Pchi2 < 0.001, I2 = 84.5%, respectively). However, there was no evidence of a difference in t-PA activity (SMD = -3.43, 95% CI: -7.95 to 1.09, Pchi2 < 0.001, I2 = 95.5%). In conclusion, statins were effective in preventing postoperative adhesion, as assessed based on gross and microscopic adhesion scores in rats.
Collapse
Affiliation(s)
- Geun Joo Choi
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06911, Republic of Korea
| | - Hee Kyung Park
- Department of Biomedical Engineering, School of Integrative Engineering, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06911, Republic of Korea
| | - Dong Su Kim
- Department of Biomedical Engineering, School of Integrative Engineering, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06911, Republic of Korea
| | - Donghyun Lee
- Department of Biomedical Engineering, School of Integrative Engineering, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06911, Republic of Korea.
| | - Hyun Kang
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06911, Republic of Korea.
| |
Collapse
|
5
|
Gürer B, Kahveci R, Gökçe EC, Ozevren H, Turkoglu E, Gökçe A. Evaluation of topical application and systemic administration of rosuvastatin in preventing epidural fibrosis in rats. Spine J 2015; 15:522-9. [PMID: 25452015 DOI: 10.1016/j.spinee.2014.10.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 09/23/2014] [Accepted: 10/19/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Epidural fibrosis is a major challenge in spine surgery, with some patients having recurrent symptoms secondary to excessive formation of scar tissue resulting in neurologic compression. One of the most important factors initiating the epidural fibrosis is assumed to be the transforming growth factor-1β (TGF-1β). Rosuvastatin (ROS) has shown to demonstrate preventive effects over fibrosis via inhibiting the TGF-1β. PURPOSE We hypothesized that ROS might have preventive effects over epidural fibrosis through the inhibition of TGF-1β pathways. STUDY DESIGN Experimental animal study. METHODS Forty-eight adult male Wistar Albino rats were equally and randomly divided into four groups (laminectomy, spongostan, topical ROS, and systemic ROS). Laminectomy was performed at the L3 level in all rats. Four weeks later, the extent of epidural fibrosis was assessed both macroscopically and histopathologically. RESULTS Our data revealed that topical application and systemic administration of ROS both were effective in reducing epidural fibrosis formation. Furthermore, the systemic administration of ROS yielded better results than topical application. CONCLUSIONS Both topical application and systemic administration of ROS show meaningful preventive effects over epidural fibrosis through multiple mechanisms. The results of our study provide the first experimental evidence of the preventive effects of ROS over epidural fibrosis.
Collapse
Affiliation(s)
- Bora Gürer
- Department of Neurosurgery, Ministry of Health, Fatih Sultan Mehmet Education and Research Hospital, 34752, Ataşehir, Istanbul, Turkey.
| | - Ramazan Kahveci
- Department of Neurosurgery, Ministry of Health, Kirikkale Yüksek Ihtisas Hospital, Baglarbasi mh. Lokman Hekim cd., Kirikkale, Turkey
| | - Emre Cemal Gökçe
- Department of Neurosurgery, Faculty of Medicine, Turgut Ozal University, Ayvali mh., Gazze cd., No:7 Etlik, Kecioren, Ankara, Turkey
| | - Huseyin Ozevren
- Department of Neurosurgery, Ministry of Health, Kirikkale Yüksek Ihtisas Hospital, Baglarbasi mh. Lokman Hekim cd., Kirikkale, Turkey
| | - Erhan Turkoglu
- Department of Neurosurgery, Ministry of Health, Diskapi Yildirim Beyazit Education and Research Hospital, Irfan Bastug cd., Diskapi, Ankara, Turkey
| | - Aysun Gökçe
- Department of Pathology, Ministry of Health, Diskapi Yildirim Beyazit Education and Research Hospital, Irfan Bastug cd., Diskapi, Ankara, Turkey
| |
Collapse
|
6
|
Mynbaev OA, Eliseeva MY, Tinelli A, Malvasi A, Kosmas IP, Medvediev MV, Babenko TI, Mazitova MI, Kalzhanov ZR, Stark M. A personalized adhesion prevention strategy: E. Arslan, T. Talih, B. Oz, B. Halaclar, K. Caglayan, M. Sipahi, Comparison of lovastatin and hyaluronic acid/carboxymethyl cellulose on experimental created peritoneal adhesion model in rats, Int. J. Surg. 12 (2) (2014) 120-124. Int J Surg 2014; 12:901-5. [PMID: 25072704 DOI: 10.1016/j.ijsu.2014.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 03/02/2014] [Accepted: 03/14/2014] [Indexed: 11/26/2022]
Affiliation(s)
- O A Mynbaev
- The International Translational Medicine & Biomodeling Research Team, Department of Applied Mathematics, Moscow Institute of Physics & Technology (State University), Dolgoprudny, Moscow Region, Russia; The Department of Obstetrics, Gynecology & Reproductive Medicine, Peoples' Friendship, University of Russia, Moscow, Russia; Laboratory of Pilot Projects, Moscow State University of Medicine & Dentistry, Moscow, Russia; The New European Surgical Academy, Berlin, Germany.
| | - M Yu Eliseeva
- The Department of Obstetrics, Gynecology & Reproductive Medicine, Peoples' Friendship, University of Russia, Moscow, Russia
| | - A Tinelli
- Department of Obstetrics and Gynaecology, Division of Experimental Endoscopic Surgery, Imaging, Minimally Invasive Therapy and Technology, Vito Fazzi Hospital, Piazza Muratore, Lecce, Italy
| | - A Malvasi
- Department of Obstetrics and Gynecology, Santa Maria Hospital, Bari, Italy
| | - I P Kosmas
- Xatzikosta General Hospital, Ioannina, Ioannina, Greece
| | - M V Medvediev
- State Establishment "Dnepropetrovsk Medical Academy of Health Ministry of Ukraine", Dnepropetrovsk, Ukraine
| | - T I Babenko
- Stavropol State Medical Academy, Stavropol, Russia
| | | | - Zh R Kalzhanov
- School of Health and Human Sciences, University of Essex, UK
| | - M Stark
- The New European Surgical Academy, Berlin, Germany
| |
Collapse
|
7
|
Alonso JDM, Alves ALG, Watanabe MJ, Rodrigues CA, Hussni CA. Peritoneal response to abdominal surgery: the role of equine abdominal adhesions and current prophylactic strategies. Vet Med Int 2014; 2014:279730. [PMID: 24587939 PMCID: PMC3918701 DOI: 10.1155/2014/279730] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 11/22/2013] [Indexed: 12/27/2022] Open
Abstract
Intra-abdominal adhesions constitute a significant clinical and surgical problem that can lead to complications such as pain and bowel occlusion or subocclusion. These adhesions are frustrating and potentially fatal, representing a major postoperative complication in abdominal surgery. It is estimated that 32% of horses undergoing laparotomy will present clinical symptoms due to adhesions, but the true prevalence is not known because a large proportion of animals with postoperative recurrent colics are medically treated or submitted to euthanasia without necropsy. Adhesions are highly cellular, vascularized, dynamic structures that are influenced by complex signaling mechanisms. Understanding their pathogenesis could assist in applying better therapeutic strategies and in developing more effective antiadhesion products. Currently, there are no definitive strategies that prevent adhesion formation, and it is difficult to interpret the results of existing studies due to nonstandardization of an induction model and evaluation of their severity. The best clinical results have been obtained from using minimally traumatic surgical techniques, anti-inflammatory agents, antimicrobials, anticoagulants, and mechanical separation of serosal surfaces by viscous intraperitoneal solutions or physical barriers. This paper aims to review adhesion formation pathogenesis, guide the understanding of major products and drugs used to inhibit adhesion formation, and address their effectiveness in the equine species.
Collapse
Affiliation(s)
- Juliana de Moura Alonso
- School of Veterinary Medicine and Animal Science, UNESP, University Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Ana Liz Garcia Alves
- School of Veterinary Medicine and Animal Science, UNESP, University Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Marcos Jun Watanabe
- School of Veterinary Medicine and Animal Science, UNESP, University Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Celso Antonio Rodrigues
- School of Veterinary Medicine and Animal Science, UNESP, University Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Carlos Alberto Hussni
- School of Veterinary Medicine and Animal Science, UNESP, University Estadual Paulista, Botucatu, São Paulo, Brazil
| |
Collapse
|
8
|
Niwa D, Koide M, Fujie T, Goda N, Takeoka S. Application of nanosheets as an anti-adhesion barrier in partial hepatectomy. J Biomed Mater Res B Appl Biomater 2013; 101:1251-8. [DOI: 10.1002/jbm.b.32937] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2012] [Revised: 12/08/2012] [Accepted: 01/15/2013] [Indexed: 11/07/2022]
Affiliation(s)
- Daisuke Niwa
- Department of Life Sciences and Medical Biosciences; Graduate School of Advanced Science and Engineering; Waseda University; 2-2, Wakamatsu-cho Shinjuku-ku Tokyo 162-8480 Japan
| | - Masatsugu Koide
- Department of Life Sciences and Medical Biosciences; Graduate School of Advanced Science and Engineering; Waseda University; 2-2, Wakamatsu-cho Shinjuku-ku Tokyo 162-8480 Japan
| | - Toshinori Fujie
- Department of Life Sciences and Medical Biosciences; Graduate School of Advanced Science and Engineering; Waseda University; 2-2, Wakamatsu-cho Shinjuku-ku Tokyo 162-8480 Japan
| | - Nobuhito Goda
- Department of Life Sciences and Medical Biosciences; Graduate School of Advanced Science and Engineering; Waseda University; 2-2, Wakamatsu-cho Shinjuku-ku Tokyo 162-8480 Japan
| | - Shinji Takeoka
- Department of Life Sciences and Medical Biosciences; Graduate School of Advanced Science and Engineering; Waseda University; 2-2, Wakamatsu-cho Shinjuku-ku Tokyo 162-8480 Japan
| |
Collapse
|
9
|
Dinarvand P, Farhadian S, Seyedjafari E, Shafiee A, Jalali A, Sanaei-rad P, Dinarvand B, Soleimani M. Novel approach to reduce postsurgical adhesions to a minimum: Administration of losartan plus atorvastatin intraperitoneally. J Surg Res 2013; 181:91-8. [DOI: 10.1016/j.jss.2012.05.035] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 05/02/2012] [Accepted: 05/09/2012] [Indexed: 12/08/2022]
|
10
|
Lalountas M, Ballas KD, Michalakis A, Psarras K, Asteriou C, Giakoustidis DE, Nikolaidou C, Venizelos I, Pavlidis TE, Sakantamis AK. Postoperative adhesion prevention using a statin-containing cellulose film in an experimental model. Br J Surg 2012; 99:423-9. [PMID: 22246725 DOI: 10.1002/bjs.7817] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2011] [Indexed: 02/05/2023]
Abstract
BACKGROUND Intraperitoneal adhesions are a common problem in abdominal surgery. The aim of this study was to compare the effectiveness of Statofilm, a novel antiadhesive film based on cross-linked carboxymethylcellulose and atorvastatin, with that of sodium hyaluronate-carboxymethylcellulose (Seprafilm(®)) in the prevention of postoperative intraperitoneal adhesions in rats. METHODS One hundred male Wistar rats underwent a laparotomy and adhesions were induced by caecal abrasion. The animals were allocated to five groups: a control group with no adhesion barrier, Seprafilm(®) group, placebo group with a film containing carboxymethylcellulose without atorvastatin, and low- and high-dose groups with films containing carboxymethylcellulose and atorvastatin 0·125 and 1 mg per kg bodyweight respectively. Adhesions were classified by two independent surgeons 2 weeks after surgery. Caecal biopsies were obtained for histological evaluation of fibrosis, inflammation and vascular proliferation. RESULTS All antiadhesive film groups (Seprafilm(®), placebo, low-dose and high-dose) had statistically significant adhesion reduction compared with the control group (P < 0·001, P = 0·015, P < 0·001 and P < 0·001 respectively). The low-dose Statofilm was superior to Seprafilm(®) in terms of adhesion prevention (P = 0·001). Adhesions were present in three-quarters of rats in the Seprafilm(®) group, but only one-quarter in the low-dose Statofilm group. CONCLUSION The data suggest that the newly developed adhesion barrier Statofilm has better results than Seprafilm(®) in preventing postoperative adhesions in rats. A low-dose atorvastatin-containing film, such as Statofilm, could be evaluated for future clinical application.
Collapse
Affiliation(s)
- M Lalountas
- Laboratory of Scientific Research and Experimental Surgery, Second Propedeutical Department of Surgery, Medical School, Aristotle University, and Hippokration General Hospital, Thessaloniki, Greece.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Intra-abdominal use of phosphodiesterase type 4 inhibitor in postoperative adhesion prevention: an experimental study on mice. Dis Colon Rectum 2012; 55:345-50. [PMID: 22469803 DOI: 10.1097/dcr.0b013e31824202f3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The study was designed to assess the value of intraperitoneal use of rolipram for adhesion prevention and to compare the results with placebo and a sodium hyaluronate/carboxymethylcellulose absorbable barrier (Seprafilm), in a murine cecal abrasion model. DESIGNS Twenty-four Balb/c mice were subjects of this study. Intra-abdominal adhesions were created with a multiple-abrasion model consisting of meticulous abrasion of the cecum and small-bowel segments with strokes of a dental toothbrush. Animals in groups R (n = 8) received 1 mL of rolipram intraperitoneally. Seprafilm was placed over the viscera under the incision in group S animals (n = 8). Group C animals (n = 8) were reserved as control and received nothing. Animals were killed on day 22. MAIN OUTCOME MEASURES The adhesions were evaluated with 2 different observational scoring systems, the Majuzi System and the Linsky Scale. After completion of observational evaluation, the cecum and small bowel of the animals were excised and sent to the pathology laboratory for histopathologic examination. The extent of inflammatory response, the extent of the fibrotic reaction, the extent of the necrosis and abscess formation, and the extent of foreign body reaction were histologically evaluated. RESULTS The mean Majuzi System scores of groups R and S were similar to each other and significantly less than control group. Also, all scores of the Linsky Scale in group R were similar to those in group S, and significantly less than those in the control group. Histologically, the mean score of inflammatory response in group R was less than both those in group C and group S. The mean score of fibrotic reaction in group R was significantly less than those in the control group. CONCLUSION These results indicate that rolipram may be an effective material in prevention of postoperative intra-abdominal adhesions, but it is obvious that further studies are needed to validate the results of this limited initial study.
Collapse
|
12
|
Lalountas MA, Ballas KD, Skouras C, Asteriou C, Kontoulis T, Pissas D, Triantafyllou A, Sakantamis AK. Preventing intraperitoneal adhesions with atorvastatin and sodium hyaluronate/carboxymethylcellulose: a comparative study in rats. Am J Surg 2010; 200:118-23. [PMID: 20637345 DOI: 10.1016/j.amjsurg.2009.06.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2009] [Revised: 05/27/2009] [Accepted: 06/01/2009] [Indexed: 12/08/2022]
Abstract
OBJECTIVES The aim of this study was to compare the effectiveness of atorvastatin with the sodium hyaluronate/carboxymethylcellulose (HA/CMC, Seprafilm; Genzyme; Genzyme Biosurgery Corporation, Cambridge, MA) in preventing postoperative intraperitoneal adhesion formation in rats. METHODS Sixty Wistar rats underwent a laparotomy, and adhesions A were induced by cecal abrasion. The animals were divided into 4 groups: group 1, control A; group 2, (A + atorvastatin); group 3, (A + HA/CMC), and group 4, (A + atorvastatin + HA/CMC). The atorvastatin (groups 2 and 4) and HA/CMC (groups 3 and 4) were administered intraperitoneally before the abdominal wall was closed. After 14 days, adhesions were classified by 2 independent surgeons. RESULTS The adhesion scores (mean +/- standard deviation) for groups 1, 2, 3, and 4 were 2.93 +/- .59, 1.85 +/- 1.07, 1.80 +/- .86, and 1.93 +/- .70, respectively. The differences in adhesion scores among all 3 preventive groups (groups 2, 3, and 4) were statistically significant when compared with the control group (P = .005, P = .002, and P = .009, respectively). CONCLUSIONS These data suggest that atorvastatin, administered intraperitoneally, is as effective as HA/CMC without an expectable additive effect in preventing postoperative adhesions in rats.
Collapse
Affiliation(s)
- Miltiadis A Lalountas
- Second Propedeutical Department of Surgery, Aristotle University, Medical School, Hippokration Hospital, 49 Konstantinoupoleos Str., Thessaloniki, Greece.
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Kamel RM. Prevention of postoperative peritoneal adhesions. Eur J Obstet Gynecol Reprod Biol 2010; 150:111-8. [PMID: 20382467 DOI: 10.1016/j.ejogrb.2010.02.003] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 12/15/2009] [Accepted: 02/01/2010] [Indexed: 11/17/2022]
Abstract
Adhesions are bands of tissue that connect organs together. It is frequently reported after surgery and remains a major problem for health and society. Efforts to prevent or reduce peritoneal adhesions mostly have been unsuccessful, hindered by their empirical basis, lack of good predictive animal models and complexity of adhesion pathogenesis. Although a good surgical technique is a crucial part of adhesion prevention, the technique alone cannot effectively eliminate the adhesions. Thus, there remains a room for further research. A comprehensive literature review of published experimental and clinical studies of adhesion prevention was carried out at the University of Bristol electronic library (MetaLib) with cross-search of seven different medical databases (AMED-Allied and Complementary Medicine Database, BIOSIS Previews on Web of Knowledge, Cochrane Library, Embase and Medline on Web of Knowledge, OvidSP and PubMed) by using key words (peritoneal adhesions, postoperative adhesions, prevention) to explore the progress in different surgical strategies and adjuvant materials used to prevent adhesions formation and reformation. By the end of the study, recommendations formulated for surgeons to be followed during the operations to prevent, as much as possible, the postoperative adhesions.
Collapse
Affiliation(s)
- Remah M Kamel
- European University Diploma of Operative Endoscopy, France.
| |
Collapse
|
14
|
Imai A, Suzuki N. Topical non-barrier agents for postoperative adhesion prevention in animal models. Eur J Obstet Gynecol Reprod Biol 2010; 149:131-5. [DOI: 10.1016/j.ejogrb.2009.12.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Revised: 12/08/2009] [Accepted: 12/21/2009] [Indexed: 11/28/2022]
|
15
|
Srinivasa S, Kahokehr AA, Sammour T, Yu TC, Abbas SM, Hill AG. Use of statins in adhesive small bowel obstruction. J Surg Res 2010; 162:17-21. [PMID: 20452619 DOI: 10.1016/j.jss.2010.02.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Revised: 01/27/2010] [Accepted: 02/22/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Adhesive small bowel obstruction (ASBO) causes considerable morbidity and may require surgical intervention. The role of statins in adhesion prevention is of increasing interest, though no investigation of its impact on ASBO and operative rates has been conducted. This study investigates the impact of statin use on operative rates in ASBO. METHODS A retrospective review of all patients with ASBO within our institution from January 1997 to December 2007 was conducted. Demographic data, potential confounders, and treatment received (conservative/operative) were recorded. Statistical significance was determined using the two-tailed Fisher's exact test for categorical data and the Mann-Whitney U test for continuous data. Univariate and logistic regression were conducted to control for potential known confounders. RESULTS There were 419 cases of ASBO with 253 (60.4%) females. The median age of diagnosis was 62 (15-93) years and the median ASA score was 2 (1-4). Forty-nine (11.7%) patients required operative management, the median day-stay was three (1-154) d and 151 (36%) patients were taking statins. On univariate analysis, statin use was associated with decreased operative rates (P = 0.02). The relative risk was 0.46 with an absolute risk reduction of 7.9% (95% CI: 2.1%-13.7%). The number needed to treat was 13 (NNT = 13; 95% CI: 7.3-46.8). Statin use was associated with decreased operative rates using a logistic regression model (P = 0.04). CONCLUSION Statin use is independently associated with decreased operative rates in ASBO.
Collapse
Affiliation(s)
- Sanket Srinivasa
- Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand
| | | | | | | | | | | |
Collapse
|
16
|
Imai A, Takagi H, Matsunami K, Suzuki N. Non-barrier agents for postoperative adhesion prevention: clinical and preclinical aspects. Arch Gynecol Obstet 2010; 282:269-75. [DOI: 10.1007/s00404-010-1423-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2010] [Accepted: 03/01/2010] [Indexed: 11/24/2022]
|
17
|
HMG-CoA reductase inhibitor lovastatin upregulates plasminogen activator production through RhoA-signaling in peritoneal cell line Met5A. ACTA ACUST UNITED AC 2009. [DOI: 10.1007/s10397-009-0546-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
|
18
|
Stark M, Hoyme UB, Stubert B, Kieback D, di Renzo GC. Post-cesarean adhesions–are they a unique entity? J Matern Fetal Neonatal Med 2009; 21:513-6. [DOI: 10.1080/14767050802040823] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
19
|
Yilmaz B, Aksakal O, Gungor T, Sirvan L, Sut N, Kelekci S, Soysal S, Mollamahmutoglu L. Metformin and atorvastatin reduce adhesion formation in a rat uterine horn model. Reprod Biomed Online 2009; 18:436-42. [DOI: 10.1016/s1472-6483(10)60106-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|