Kece Can, Ulas Murat, Ozer Ilter, Ozel Ummuhani, Bilgehan Ayse, Aydog Gulden, Dalgic Tahsin, Oymaci Erkan, Bostanci Birol
Gastroenterologic Surgery, Yuksek Ihtisas Hospital, Ankara, Turkey.
J Laparoendosc Adv Surg Tech A. 2010 Feb;20(1):25-30. doi: 10.1089/lap.2009.0216.
We aimed to investigate the role of the carbon-dioxide (CO(2)) pneumoperitoneum on the prevention of postoperative adhesion formation.
Thirty adult male Sprague-Dawley rats (250-350 g) were used for this study. The rats were randomly divided into three groups; in the sham group (n = 10) only, laparotomy was made, in group 2 (n = 10), a pneumoperitoneum was applied for a half-hour duration, followed by laparatomy, and in group 3 (n = 10), pneumoperitoenum time was 2 hours and after a pneumoperitoneum laparotomy was made. A cecal abrasion model was studied for making an adhesion formation. On day 14, all rats were sacrificed and adhesions were scored. Tissue samples from adhesions and peritonea and the cecum wall were examined, both pathologically and biochemically, for tissue hydroxyproline content.
There was a statistically significant difference between the control and pneumoperitoneum groups, regarding adhesion numbers and grades (P < 0.001). Cecal tissue hydroxypyroline content level was lower in group 1, and statistically significant differences were observed between groups 1, 2, and 3 regarding hydroxyproline content (P < 0.001). There was a statistically significant difference between the control and pneumoperitoneum groups regarding inflammation (P = 0.002).
Pretreatment with the CO(2) pneumoperitoneum had a prophylactic effect on postoperative adhesion formation in this study.
我们旨在研究二氧化碳气腹在预防术后粘连形成中的作用。
本研究使用30只成年雄性Sprague-Dawley大鼠(250 - 350克)。大鼠被随机分为三组;仅在假手术组(n = 10)进行剖腹手术,在第2组(n = 10)中,施加半小时气腹,然后进行剖腹手术,在第3组(n = 10)中,气腹时间为2小时,气腹后进行剖腹手术。采用盲肠擦伤模型来诱导粘连形成。在第14天,处死所有大鼠并对粘连进行评分。对粘连组织、腹膜和盲肠壁的组织样本进行病理和生化检查,以检测组织羟脯氨酸含量。
在粘连数量和等级方面,对照组和气腹组之间存在统计学显著差异(P < 0.001)。第1组盲肠组织羟脯氨酸含量水平较低,在第1、2和3组之间观察到羟脯氨酸含量存在统计学显著差异(P < 0.001)。在炎症方面,对照组和气腹组之间存在统计学显著差异(P = 0.002)。
在本研究中,二氧化碳气腹预处理对术后粘连形成具有预防作用。