Novosti
Khirurgii
This journal is
indexed in Scopus









Year 2017 Vol. 25 No 4

SCIENTIFIC PUBLICATINS
EXPERIMENTAL SURGERY

DOI: https://dx.doi.org/10.18484/2305-0047.2017.4.333   |  

A.V. ZHURA1, S.I. TRATSYAK 1, V.J. KHRYSHCHANOVICH2, Z.A. MAKAREVICH1

EXPERIMENTAL MODEL OF PERITONEAL ADHESION

EE Belarusian State Medical University 1,
SEE Belarusian Medical Academy of Post-Graduate Education 2,
Minsk
The Republic of Belarus

Objectives. To develop an experimental model of peritoneal adhesions that is close to clinical practice, simple to implement, with a high incidenceof adhesion formation and a small number of complications.
Methods. Several experimental models were chosen with singling out three groups: injury of cecum serosa (group 1, n=6), ileum enterotomy with subsequent suturing of the defect (group 2, n=8), and model made by the authors, including the excision of the peritoneum on the contralateral sides of the abdominal wall (group 3, n=22). Third group was divided into two subgroups with and without bacterial contamination of the peritoneal cavity.
Results. There were no abdominal adhesions in animals of the first group. In future this model was abandoned. Opening of the intestinal lumen and its suturing (group 2) induced adhesions in all animals; however, it was variably localized in the peritoneal cavity. Intestinal insufficiency of sutures was observed in two cases. In addition, in second group operation time was the longest (17 min) in comparison with 7 minutes in the first group and 5 minutes in the third group. Excision of the parietal peritoneum with abdominal contamination (subgroup 3a) was characterized by the largest number of complications with the development of intra-abdominal abscesses and infiltrates, high lethality, and overproduction of adhesion process going beyond the limits of modeling. Excision of the parietal peritoneum without contamination (subgroup 3b) induced adhesion formation in 75 % of cases with the localization of adhesions in the regions of modeling only, without morbidity and mortality.
Conclusion. A suggested experimental model of peritoneal adhesions leads to adhesion formation in large number of cases with minimal number of complication, appears to be simple, and is thought to be recommended for research of the adhesion process.

Keywords: peritoneal adhesions, surgical treatment, experimental model, peritoneal injury, peritonitis, morbidity, mortality
p. 333-339 of the original issue
References
  1. Hwang HJ, An MS, Ha TK, Kim KH, Kim TH, Choi CS, et al. All the commercially available adhesion barriers have the same effect on adhesion prophylaxis? A comparison of barrier agents using a newly developed, severe intra-abdominal adhesion model. Int J Colorectal Dis. 2013 Aug;28(8):1117-25. doi: 10.1007/s00384-013-1679-78.
  2. Barbul A. Abdominal Adhesions. Curr Probl Surg. 2015 Jul;52(7):266-69. doi: 10.1067/j.cpsurg.2015.05.003.
  3. Oncel M, Remzi FH, Connor J, Fazio VW. Comparison of cecal abrasion and multiple-abrasion models in generating intra-abdominal adhesions for animal studies. Tech Coloproctol. 2005 Apr;9(1):29-33.
  4. Kayaoglu HA, Ozkan N, Hazinedaroglu SM, Ersoy OF, Koseoglu RD. An assessment of the effects of two types of bioresorbable barriers to prevent postoperative intra-abdominal adhesions in rats. Surg Today. 2005;35(11):946-50.
  5. Dietrich A, Bouzidi M, Hartwig T, Schütz A, Jonas S. Rapamycin and a hyaluronic acid-carboxymethylcellulose membrane did not lead to reduced adhesion formations in a rat abdominal adhesion model. Arch Gynecol Obstet. 2012 Jun;285(6):1603-9. doi: 10.1007/s00404-011-2184-3.
  6. Wang N, Shao Y, Mei Y, Zhang L, Li Q, Li D, et al. Novel mechanism for mesenchymal stem cells in attenuating peritoneal adhesion: accumulating in the lung and secreting tumor necrosis factor α-stimulating gene-6. Stem Cell Res Ther. 2012 Dec 6;3(6):51. doi: 10.1186/scrt142.
  7. Whang SH, Astudillo JA, Sporn E, Bachman SL, Miedema BW, Davis W, et al. In search of the best peritoneal adhesion model: comparison of different techniques in a rat model. J Surg Res. 2011 May 15;167(2):245-50. doi: 10.1016/j.jss.2009.06.020.
  8. Lucas PA, Warejcka DJ, Zhang LM, Walter HN, Young HE. Effect of rat mesenchymal stem cells on development of abdominal adhesions after surgery. Surg Res. 1996 May;62(2):229-32. doi: 10.1006/jsre.1996.0200.
  9. Treutner KH, Schumpelick V. Prevention of adhesions. New York: Springer; 1997.
  10. Soybir GR, Köksoy F, Polat C, Ozşeker A, Yalçln O, Aker Y, et al. The effects of sterile or infected bile and dropped gallstones in abdominal adhesions and abscess formation. Surg Endosc. 1997 Jul;11(7):711-13.
  11. Zühlke HV, Lorenz EM, Straub EM, Savvas V. Pathophysiology and classification of adhesions. Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir. 1990:1009-16. [Article in German]
  12. Lauder CI, Strickland A, Maddern GJ. Use of a modified chitosan-dextran gel to prevent peritoneal adhesions in a porcine hemicolectomy model. J Surg Res. 2012 Aug;176(2):448-54. doi: 10.1016/j.jss.2011.10.029.
  13. Ezberci F, Bulbuloglu E, Ciragil P, Gul M, Kurutas EB, Bozkurt S, et al. Intraperitoneal tenoxicam to prevent abdominal adhesion formation in a rat peritonitis model. Surg Today. 2006;36(4):361-66.
  14. Poehnert D, Abbas M, Kreipe HH, Klempnauer J, Winny M. High reproducibility of adhesion formation in rat with meso-stitch approximation of injured cecum and abdominal wall. Int J Med Sci. 2015; 12(1):1-6. doi: 10.7150/ijms.8870.
Address for correspondence:
220007, Republic of Belarus,
Minsk, Dzerzhinsky Ave., 83,
Belarusian State Medical University,
department of surgical diseases N2,
Tel.: + 375 (29) 668-50-21,
E-mail: ZhuraAV@bsmu.by,
Alexander V. Zhura
Information about the authors:
Zhura A.V. PhD, Assistant of department of surgical diseases N2, EE Belarusian State Medical University.
Tratsyak S.I. MD, Professor, Corresponding member of NAS of Belarus, Head of department of surgical diseases N2, EE Belarusian State Medical University.
Khryshchanovich V.J. MD, Ass. Professor, Head of department surgery, SEE Belarusian Medical Academy of Post-graduate Education.
Makarevich Z.A. Vivarium manager of EE Belarusian State Medical University.
Contacts | ©Vitebsk State Medical University, 2007