• Types and Localization of Abdominal Adhesions after Open Operations (Experimental Study)
en To content Full text of article

Types and Localization of Abdominal Adhesions after Open Operations (Experimental Study)

Paediatric Surgery (Ukraine).2022.4(77):34-39; doi 10.15574/PS.2022.77.34
Akhmedov F. T.
Main Clinical Hospital of the Armed Forces of the Ministry of Defence of the Republic of Azerbaijan, Baku

For citation: Akhmedov FT. (2022). Types and Localization of Abdominal Adhesions after Open Operations (Experimental Study). Paediatric Surgery (Ukraine). 4(77): 34-39; doi 10.15574/PS.2022.77.34.
Article received: Oct 08, 2022. Accepted for publication: Des 19, 2022.

There is a great need for more efficient and more widely used preventive treatment of post-operative abdominal adhesions.
Objective to study the type of adhesions in the abdominal cavity after open operations in the experiment.
Materials and methods. The study was conducted on 90 white outbred rats divided into three groups. We mechanically damaged the surface of the small bowel segment in all rats. The control group (group 1) included 30 rats not administered any drugs into the abdominal cavity after the small bowel segment damage. The comparison group (group 2) consisted of 30 rats, which were introduced one mL of mezogel. The study group comprised 30 rats, which were administered a 1 mL mixture of metronidazole, dextran, contrykal (in a ratio of 1:1:0.1, respectively) + O2 into the abdominal cavity; the wound of the latter was closed using a layered suture technique. On days 5, 10 and 21, the tissues taken from the suture site, peritoneum, damaged small bowel segment, liver, and omentum were analysed histologically.
Results. On day 10 in groups 1 and 2, compared to day 5, the proportion of filmy adhesions decreased by 45.9% (p=0.004), but the proportion of dense adhesions increased by 64.7%. The comparative between-group analysis on day 5 in groups 1 and 2 revealed no difference in the proportion of filmy adhesions, whereas in group 3 the proportion of filmy adhesions was 4% higher and the proportion of dense adhesions was 16.5% lower. Planar adhesions predominated in all groups.
Conclusions. There were more filmy adhesions seen on day 1, and the complete dense adhesion formation was observed by day 21. Planar adhesions predominated (54.5 – 60.0%). The area of postoperative sutures was involved in the adhesion formation. The adhesions in the sutures – peritoneum area as well as the omental adhesions were detected in all animals. Introduction of drugs, mezogel or a mixture of metronidazole, dextran, contrykal + O2, into the abdominal cavity contributed to the reduction of adhesions between the small bowel loops.
The experiments with laboratory animals were provided in accordance with all bioethical norms and guidelines.
No conflict of interests was declared by the author.
Keywords: peritoneum, omentum, adhesion modelling, anti-adhesion agents, type of adhesions, localization.

REFERENCES

1. Arslan E, Irkorucu O, Sozutek A, Cetinkunar S, Reyhan E, Yaman A et al. (2016). The potential efficacy of Survanta (r) and Seprafilm (r) on preventing intra-abdominal adhesions in rats. Acta Cir Bras. 31 (6): 389-395. https://doi.org/10.1590/S0102-865020160060000005; PMid:27355746

2. Belozertseva IV (ed), Blinova DV, Krasilshchikova MS. (2017). Guidelines for the maintenance and use of laboratory animals. Per. from English. Moscow: IRBIS: 336.

3. De Wilde RL, Devassy R, Broek RPGT, Miller CE, Adlan A, Aquino P et al. (2022, Mar 8). The Future of Adhesion Prophylaxis Trials in Abdominal Surgery: An Expert Global Consensus. J Clin Med. 11 (6): 1476. https://doi.org/10.3390/jcm11061476; PMid:35329802 PMCid:PMC8950418

4. Ito T, Shintani Y, Fields L, Shiraishi M, Podaru M-N, Kainuma S et al. (2021). Cell barrier function of resident peritoneal macrophages in post-operative adhesions. Nat Commun. 12: art. 2232. https://doi.org/10.1038/s41467-021-22536-y; PMid:33854051 PMCid:PMC8046819

5. Karpov MA, Shkurupy VA, Troitskii AV. (2021). The Study of Efficiency of the Approach to Prevent the Adhesions in the Abdominal Cavity of Rats. Bull Exp Biol Med. 171: 416-420. https://doi.org/10.1007/s10517-021-05240-1; PMid:34542744

6. Krielen P, Stommel MWJ, Pargmae P, Bouvy ND, Bakkum EA, Ellis H. et al. (2020). Adhesion-related readmissions after open and laparoscopic surgery: a retrospective cohort study (SCAR update). Lancet. 395 (10217): 33-41. https://doi.org/10.1016/S0140-6736(19)32636-4; PMid:31908284

7. Meshkova OA, Bogdanov DIu, Matveev NL, Kurganov IA. (2015). Application of modern antiadhesive agents in surgery. Endoscopic Surgery. 21 (3): 37‑42. https://doi.org/10.17116/endoskop201521337-42

8. National Research Council (US) Committee for the Update of the Guide for the Care, Use of Laboratory Animals. (2011). Guide for the Care and Use of Laboratory Animals. 8th edition. Washington (DC): National Academies Press (US). The National Academies Collection: Reports funded by National Institutes of Health: 246.

9. Stapleton LM, Steele AN, Wang H, Lopez Hernandez H, Yu AC, Paulsen MJ et al. (2019). Use of a supramolecular polymeric hydrogel as an effective post-operative pericardial adhesion barrier. Nat Biomed Eng. 3 (8): 611-620. https://doi.org/10.1038/s41551-019-0442-z; PMid:31391596

10. Stommel MWJ, Ten Broek RPG, Strik C, Slooter GD, Verhoef C, Grünhagen DJ et al. (2018). Multicenter Observational Study of Adhesion Formation After Open-and Laparoscopic Surgery for Colorectal Cancer. Ann Surg. 267 (4): 743-748. https://doi.org/10.1097/SLA.0000000000002175; PMid:28207436

11. Ten Broek RPG, Krielen P, Di Saverio S, Coccolini F, Biffl WL, Ansaloni L et al. (2018). Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group. World J Emerg Surg. 13: 24. https://doi.org/10.1186/s13017-018-0185-2; PMid:29946347 PMCid:PMC6006983

12. Urkan M, Özerhan İH, Ünlü A, Can MF, Öztürk E, Günal A et al. (2017). Prevention of Intraabdominal Adhesions: An Experimental Study Using Mitomycin-C and 4% Icodextrin. Balkan Med J. 34 (1): 35-40. https://doi.org/10.4274/balkanmedj.2015.1359; PMid:28251021 PMCid:PMC5322518

13. Van Steensel S, Liu H, Vercoulen TF, Hadfoune M, Breukink SO, Stassen LP et al. (2021). Prevention of intra-abdominal adhesions by a hyaluronic acid gel; an experimental study in rats. J Biomater Appl. 35 (7): 887-897. https://doi.org/10.1177/0885328220954188; PMid:32878535

14. Vediappan RS, Bennett C, Bassiouni A, Smith M, Finnie J, Trochsler M et al. (2020). A Novel Rat Model to Test Intra-Abdominal Anti-adhesive Therapy. Front. Surg. 7: 12. https://doi.org/10.3389/fsurg.2020.00012; PMid:32322586 PMCid:PMC7158702

15. Waldron MG, Judge C, Farina L, O'Shaughnessy A, O'Halloran M. (2022). Barrier materials for prevention of surgical adhesions: systematic review. BJS Open. 6 (3): zrac075. https://doi.org/10.1093/bjsopen/zrac075; PMid:35661871 PMCid:PMC9167938

16. Wei G, Chen X, Wang G, Fan L, Wang K, Li X. (2016). Effect of Resveratrol on the Prevention of Intra-Abdominal Adhesion Formation in a Rat Model. Cell Physiol Biochem. 39: 33-46. https://doi.org/10.1159/000445603; PMid:27322053