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.
Subject(s)
Animals , Male , Rats , Fibrinolytic Agents/therapeutic use , Hyaluronic Acid/therapeutic use , Peritoneal Diseases/drug therapy , Phosphatidylcholines/therapeutic use , Postoperative Complications/drug therapy , Tissue Plasminogen Activator/therapeutic use , Disease Models, Animal , Drug Combinations , Drug Evaluation, Preclinical , Drug Therapy, Combination , Peritoneal Diseases/prevention & control , Postoperative Complications/prevention & control , Rats, Wistar , Tissue Adhesions/drug therapy , Tissue Adhesions/prevention & controlABSTRACT
Se diseñó un experimento para conocer cuál de los componentes de un concentrado proteico de vicia faba previno las alteraciones producidas por una dieta hipercolesterolémica en las lipoproteínas del plasma de ratas. Se observó que la lecitina poliinsaturada evitaba en gran medida las modificaciones provocadas po una dieta hipercolesterolémica sobre la distribución del colesterol y la proteína en 5 fracciones lipoproteicas. Este fosfolipido mantuvo los índices aterogénicos en valores cercanos a los encontrados en animales que consumieron una dieta estándar. La saponina mostró un efecto limitado sobre los indicadores estudiados. Se demuestra que la lecitina poliinsaturada es la que ejerce el efecto preventivo producido por el concentrado proteico de vicia faba