Arung Willy, Jehaes François, Cheramy Jean-Paul, Defraigne Jean-Olivier, Meurisse Michel, Honoré Pierre, Drion Pierre, Detry Olivier
1 Centre de Recherche et Développement en Chirurgie (CREDEC), GIGA- Cardiovascular Sciences, University of Liege (ULg), Liege, Belgium.
J Invest Surg. 2013 Dec;26(6):340-6. doi: 10.3109/08941939.2013.810316. Epub 2013 Aug 8.
No systemic preventive therapy has been successful in inhibiting the development of postoperative peritoneal adhesions (PPAs).
The aim of this study was to evaluate the potential effects of 5 day administration of parecoxib, on PPA prevention and on suture or wound healing in rats.
In a model of PPAs induced by peritoneal electrical burn, 30 rats were randomized into 3 groups according to parecoxib administration route (control; intraperitoneal (IP); intramuscular (IM)). Plasma and peritoneal levels of PAI-1 and tPA were measured at T0, after 90 min of surgery (T90), and on postoperative day 10 (D10). In a cecum resection model, 20 rats were randomized into two groups (control and IP parecoxib), and abdominal wound healing and suture leakage were assessed at D10. In both models, PPAs were evaluated quantitatively and qualitatively on D10.
Administration of parecoxib significantly decreased the quantity (p < .05) and the severity (p < .01) of PPAs in both models. In addition, parecoxib administration did not cause healing defects or infectious complications in the two models. In the peritoneal burn model, IP or IM parecoxib administration inhibited the increase of postoperative plasma and peritoneum PAI-1 levels, an increase that was observed in the control group (p < .01). No anastomosis leakage could be demonstrated in both groups in the cecum resection model.
This study showed that, in these rat models, parecoxib might reduce PPA formation. Confirmation of the safety of parecoxib on intestinal anastomoses is required and should be investigated in further animal models.
尚无全身性预防疗法能成功抑制术后腹膜粘连(PPA)的形成。
本研究旨在评估帕瑞昔布5天给药对大鼠PPA预防及缝线或伤口愈合的潜在影响。
在腹膜电烧伤诱导的PPA模型中,30只大鼠根据帕瑞昔布给药途径随机分为3组(对照组;腹腔内(IP);肌肉内(IM))。在T0、手术90分钟后(T90)和术后第10天(D10)测量血浆和腹膜中PAI-1和tPA的水平。在盲肠切除模型中,20只大鼠随机分为两组(对照组和IP帕瑞昔布组),并在D10评估腹部伤口愈合和缝线渗漏情况。在两个模型中,均在D10对PPA进行定量和定性评估。
在两个模型中,帕瑞昔布给药均显著降低了PPA的数量(p < 0.05)和严重程度(p < 0.01)。此外,帕瑞昔布给药在两个模型中均未导致愈合缺陷或感染并发症。在腹膜烧伤模型中,IP或IM帕瑞昔布给药抑制了术后血浆和腹膜PAI-1水平的升高,而对照组中观察到了这种升高(p < 0.01)。在盲肠切除模型中,两组均未发现吻合口渗漏。
本研究表明 在这些大鼠模型中,帕瑞昔布可能减少PPA的形成。需要确认帕瑞昔布对肠吻合术的安全性,并应在进一步的动物模型中进行研究。