Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8501, Japan.
J Surg Res. 2013 Jan;179(1):e13-9. doi: 10.1016/j.jss.2012.01.056. Epub 2012 Apr 1.
Progress in medical technology and improvements in prognosis have led to an increase in polysurgery. However, postoperative pleural adhesion leads to poor visualization, bleeding, and lung and vascular trauma during subsequent surgeries. To date, there have been no appropriate anti-adhesive agents to prevent pleural adhesion. The aim of this study was to investigate the anti-adhesive effects of commercially available anti-adhesive agents and a newly developed powder-type anti-adhesive agent.
In 48 male rats, we performed thoracotomy at the fifth intercostal space. We randomized animals into four groups: normal saline, Seprafilm, Interceed, and aldehyde dextran and ε-poly(L-lysine) powder (D-L powder). W killed animals on Day 7 or 28 to evaluate the severity, length, gross appearance, and pathological appearance of adhesion formation.
Adhesion length in the D-L powder group was significantly shorter than in the control group (P < 0.05) on both Days 7 and 28. Pathologically, all anti-adhesive materials remained on the lung surface on Day 7. On Day 28, only Interceed remained on the lung surface, in which small vessels were present. We also demonstrated the usage of D-L powder during video-assisted thoracic surgery in pigs, and found it easy to administer via the trocar sleeve.
We found D-L powder to be effective for preventing postoperative pleural adhesion, although Seprafilm and Interceed are also somewhat effective. However, D-L powder is easier to administer during video-assisted thoracic surgery.
医疗技术的进步和预后的改善导致了多手术的增加。然而，术后胸膜粘连导致在随后的手术中可视化不良、出血以及肺和血管损伤。迄今为止，还没有合适的防粘连剂来预防胸膜粘连。本研究旨在研究市售防粘连剂和新开发的粉末型防粘连剂的防粘连效果。
在 48 只雄性大鼠中，我们在第五肋间隙进行开胸手术。我们将动物随机分为四组：生理盐水、Seprafilm、Interceed 和醛基右旋糖酐和 ε-聚（L-赖氨酸）粉（D-L 粉）。我们在第 7 天或第 28 天处死动物，以评估粘连形成的严重程度、长度、大体外观和病理外观。
在第 7 天和第 28 天，D-L 粉组的粘连长度明显短于对照组（P<0.05）。在第 7 天，所有防粘连材料仍保留在肺表面。在第 28 天，只有 Interceed 留在肺表面，其中存在小血管。我们还在猪的电视辅助胸腔镜手术中展示了 D-L 粉的使用，发现它很容易通过套管进行给药。
我们发现 D-L 粉可有效预防术后胸膜粘连，尽管 Seprafilm 和 Interceed 也有一定效果。然而，D-L 粉在电视辅助胸腔镜手术中更容易给药。
