Yigit Ozgur, Uslu Coskun Berna, Coskun Halil, Yilmaz Banu, Alkan Seyhan, Cinar Ugur, Dadas Burhan
Department of Otorhinolaryngology, Head and Neck Surgery, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
Laryngoscope. 2004 Sep;114(9):1668-73. doi: 10.1097/00005537-200409000-00031.
This study was conducted to compare the effectiveness of two anti-adhesive barriers (Seprafilm and Interceed) for reducing adhesions after thyroidectomy in a rat model. The anti-adhesive barriers are suggested for use in repeated surgeries in general and the gynecologic fields in particular.
Controlled, randomized study.
Twenty-eight male Wistar Albino rats that underwent right subtotal thyroidectomy were randomly assigned to three groups. One group received Seprafilm (n = 10), and the other received Interceed (n = 10) as anti-adhesive barriers. The third group was the control group (n = 8). At postoperative day 14, the rats were killed under general anesthesia, and the surgical fields were evaluated for the adhesion formation. The extent of the adhesion formation is scored from 0 (no adhesions) to 2 (fibrous adhesions that required sharp dissection). Histopathologically, chronic inflammation, histiocyte, fibroblast, fibrosis, collagen, vascularization, granuloma, giant cell, and fat necrosis were examined.
All the subjects in the control group, 7 of 10 in the Interceed group, and 4 of 10 in the Seprafilm group needed to be dissected bluntly or sharply. There was significant difference between the Seprafilm and the control group (P < .05) whereas there was no significant difference between the Interceed group and the control group (P > .05). When examined histopathologically, the criteria showing adhesion, such as fibrosis, fibroblast, and collagen were higher in the control group compared with the Seprafilm and Interceed groups. There was no significant difference between the Seprafilm and Interceed groups, whereas a significant difference was found between these two groups and the control group.
This study suggests that both Seprafilm and Interceed decrease the incidence of posthyroidectomy adhesions in a rat model. Both agents showed no foreign body reaction.
本研究旨在比较两种抗粘连屏障（Seprafilm和Interceed）在大鼠甲状腺切除术后减少粘连的有效性。一般而言，尤其是在妇科领域，抗粘连屏障被建议用于重复手术。
对照、随机研究。
28只接受右侧甲状腺次全切除术的雄性Wistar白化大鼠被随机分为三组。一组接受Seprafilm（n = 10），另一组接受Interceed（n = 10）作为抗粘连屏障。第三组为对照组（n = 8）。术后第14天，大鼠在全身麻醉下处死，评估手术区域的粘连形成情况。粘连形成程度从0分（无粘连）到2分（需要锐性分离的纤维粘连）进行评分。组织病理学上，检查慢性炎症、组织细胞、成纤维细胞、纤维化、胶原蛋白、血管生成、肉芽肿、巨细胞和脂肪坏死情况。
对照组所有受试者、Interceed组10只中的7只以及Seprafilm组10只中的4只需要钝性或锐性分离。Seprafilm组与对照组之间存在显著差异（P < 0.05），而Interceed组与对照组之间无显著差异（P > 0.05）。组织病理学检查时，对照组中显示粘连的指标，如纤维化、成纤维细胞和胶原蛋白，高于Seprafilm组和Interceed组。Seprafilm组和Interceed组之间无显著差异，但这两组与对照组之间存在显著差异。
本研究表明，Seprafilm和Interceed均可降低大鼠甲状腺切除术后粘连的发生率。两种药物均未显示异物反应。
