Year 2019 Vol. 27 No 4

SCIENTIFIC PUBLICATIONS
EXPERIMENTAL SURGERY

D.B. AUZHANOV 1, M.ZH. AYMAGAMBETOV 1, ZH.A. ZHAGIPAROVA 1, Y. NOSO 2

EFFECT OF AZATHIOPRINE ON THE FORMATION OF ADHESIVE PROCESS OF THE ABDOMINAL CAVITY IN EXPERIMENT

Semey State Medical University, The Republic of Kazakhstan 1,
Shimane University, Faculty of Medicine, Izumi, Japan 2

Objective. Study of the azathioprine antimetabolite effect on the formation of postoperative adhesions in experiment on a rat model.
Methods. The main experiment was performed on 30 (4-5-month-old) male Wistar rats. The operation of Bloor was conducted in all animals for the initiation of the adhesive process. The rats were divided into 2 groups (15 in each): the main group (MG) animals received azathioprine in a dosage of 1 mg/100 g of weight orally 1 time per day for the first 3 days (starting from the day of surgery). The control group (CG) did not receive any medications. On the 7th day, all rats were removed from the experiment. Adhesion assessment was performed by the criteria: macroscopic (quantitative assessment of adhesions the Moreno scale, qualitative assessment - the Binda scale), histological examination. The effect of the studied method on some indicators of the immune status (leukocytes, lymphocytes, CD, CD4, CD8, PN, PI) was also studied.
Results. In CG adhesions were reported in 100% (15 rats), G 80% (12 rats). While evaluating adhesions on the Moreno and Binda scales in CG, the number of adhesions was greater 38 versus 13 (p <0.001). Also, in CG, the thickness of adhesions and their strength prevailed (p<0.001). The volume of connective tissue, the proportion of collagen fibers, the degree of vascular proliferation, fibrosis in the adhesions in OG are less pronounced (p=0.029). The immune status indicators in MG after the treatment on the 7th day were reduced slightly.
Conclusions. Immunosuppression with azathioprine significantly reduces the frequency and severity of the adhesive process in the abdominal cavity. The use of the drug in a therapeutic dose for 3 days does not lead to a significant inhibition of some of the immunity important indicators (a slight decrease in leukocytes and lymphocytes by 0.3 and 0.9, a moderate decrease in T-lymphocytes by no more than 2.0, a decrease in phagocytic activity by 5.8).

Keywords: postoperative adhesions, prevention, experiments on animals, immunosuppression, rat, azathioprine
p. 369-378 of the original issue
References
  1. Nazarenko AA, Akimov VP, Malyshkin PO. Epidemiologiia, patogenez i profilaktika posleoperatsionnogo spaechnogo protsessa v briushnoi polosti. Vestn Khirurgii im II Grekova. 2016;175(5):114-18. (In Russ.)
  2. Ouaissi M, Gaujoux S, Veyrie N, Denève E, Brigand C, Castel B, Duron JJ, Rault A, Slim K, Nocca D. Post-operative adhesions after digestive surgery: their incidence and prevention: review of the literature. J Visc Surg. 2012 Apr;149(2):e104-14. doi: 10.1016/j.jviscsurg.2011.11.006
  3. Filenko BP, Zemlianoi VP, Borsak II, Ivanova AS. Spaechnaia bolezn: Profilaktika i lechenie: monogr. S-Petersburg, RF; 2013. 164 p. http://baltzdrav.ru/images/files/borsak_monography.pdf (In Russ.)
  4. Stanciu D, Menzies D. The magnitude of adhesion-related problems. Colorectal Dis. 2007 Oct;9(Suppl 2):35-38. doi: 10.1111/j.1463-1318.2007.01346.x
  5. Rizzo A, Spedicato M, Mutinati M, Minoia G, Angioni S, Jirillo F, Pantaleo M, Sciorsci RL. Peritoneal adhesions in human and veterinary medicine: from pathogenesis to therapy. A review. Immunopharmacol Immunotoxicol. 2010 Sep;32(3):481-94. doi: 10.3109/08923970903524367
  6. Mais V, Cirronis MG, Peiretti M, Ferrucci G, Cossu E, Melis GB. Efficacy of auto-crosslinkedhyaluronan gel for adhesion prevention in laparoscopy and hysteroscopy: a systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol. 2012 Jan;160(1):1-5. doi: 10.1016/j.ejogrb.2011.08.002
  7. Kumar S, Wong PF, Leaper DJ. Intra-peritoneal prophylactic agents for preventing adhesions and adhesive intestinal obstruction after non-gynaecological abdominal surgery. Cochrane Database Syst Rev. 2009 Jan 21;(1):CD005080. doi: 10.1002/14651858.CD005080.pub2
  8. Binda MM, Molinas CR, Bastidas A, Koninckx PR. Effect of reactive oxygen species scavengers, antiinflammatory drugs, and calcium-channel blockers on carbon dioxide pneumoperitoneum-enhanced adhesions in a laparoscopic mouse model. Surg Endosc. 2007 Oct;21(10):1826-34. https://www.springermedizin.de/effect-of-reactive-oxygen-species-scavengers-antiinflammatory-dr/8531612
  9. diZerega GS, Tulandi T. Prevention of intra-abdominal adhesions in gynaecological surgery. Reprod Biomed Online. 2008 Sep;17(3):303-306. doi: 10.1016/S1472-6483(10)60211-8
  10. Arung W, Drion P, Cheramy JP, Honoré P, Meurisse M, Defraigne JO, Detry O. Intraperitoneal adhesions after open or laparoscopic abdominal procedure: an experimental study in the rat. J Laparoendosc Adv Surg Tech A. 2012 Sep;22(7):651-57. doi: 10.1089/lap.2012.0102
  11. Andreeva IV, Vinogradov AA. Atlas normalnoi i ultrazvukovoi anatomii zhivota krysy [Elektronnyi resurs]. Moscow, RF: GEOTAR-Media; 2015. http://www.studentlibrary.ru/book/06-COS-2400.html (In Russ.)
  12. Hooker GD, Taylor BM, Driman DK. Prevention of adhesion formation with use of sodium hyaluronate-based bioresorbable membrane in a rat model of ventral hernia repair with polypropylene mesha randomized, controlled study. Surgery. 1999 Feb;125(2):211-16. doi: 10.1016/s0039-6060(99)70267-9
  13. Hindocha A, Beere L, Dias S, Watson A, Ahmad G. Adhesion prevention agents for gynaecological surgery: an overview of Cochrane reviews. Cochrane Database Syst Rev. 2015 Jan 6;1:CD011254. doi: 10.1002/14651858.CD011254.pub2
  14. Ahmad G, OFlynn H, Hindocha A, Watson A. Barrier agents for adhesion prevention after gynaecological surgery. Cochrane Database Syst Rev. 2015 Apr 30;(4):CD000475. doi: 10.1002/14651858.CD000475.pub3
  15. Pados G, Venetis CA, Almaloglou K, Tarlatzis BC. Prevention of intra-peritoneal adhesions in gynaecological surgery: theory and evidence. Reprod Biomed Online. 2010 Sep;21(3):290-303. doi: 10.1016/j.rbmo.2010.04.021
  16. Gasanov N, Brezhnev V, Novikova O, Grishina O, Vatsik M. Prevention of peritoneal commissures at surgical treatment of malignant swellings of abdominal organs. Khirurg. 2013;(2):46-50. (In Russ.)
  17. Sufiyarov IF, Lalipov RZ, Sibiryak SV, Shafikov RM. Influence of immtnosl ppression indited by cyclophosphamll) on development postoperative adhesion deseases. Med Vestn Bashkortostana. 2009;4(4):64-67. https://cyberleninka.ru/article/n/vliyanie-immunosupressii-indutsirovannoy-tsiklofosfamidom-na-razvitie-posleoperatsionnyh-bryushinnyh-spaek( In Russ.)
Address for correspondence:
071400, The Republic of Kazakhstan,
Semey, Abay Kunanbayev Str., 103,
Semey State Medical University,
Hospital Surgery Department.
Tel.: +7 777 264-89-42,
e-mail: daurenchik@mail.ru,
Dauren B. Auzhanov
Information about the authors:
Auzhanov Dauren B., Applicant for Doctors Degree of Semey State Medical University, Semey, Republic of Kazakhstan.
https://orcid.org/0000-0001-8378-0054
Aymagambetov Meyrbek Zh., MD, Associate Professor, Head of the Surgery Internship Department of Semey State Medical University, Semey, Republic of Kazakhstan.
https://orcid.org/0000-0002-8344-4445
Zhagiparova Zhanar A., PhD, Head of the Department of Special Disciplines of Pavlodar Branch of Semey State Medical University, Semey, Republic of Kazakhstan.
https://orcid.org/0000-0002-5619-3505
Noso Yoshihiro, MD, PhD, Professor of the General Medicine Department of the Faculty of Medicine, Shimane University, Izumi, Japan.
https://orcid.org/0000-0003-3477-1260
Contacts | ©Vitebsk State Medical University, 2007-2023