Cwalinski Jarosław, Staniszewski Ryszard, Baum Ewa, Jasinski Tomasz, Mackowiak Beata, Bręborowicz Andrzej
Department of Pathophysiology, Poznań University of Medical Sciences Poland.
Int J Clin Exp Med. 2015 Jun 15;8(6):8828-34. eCollection 2015.
Normal saline is commonly used for rinsing the abdominal cavity and many surgeons claim that it is not harmful to peritoneum. We found in patients treated with laparoscopic surgery, that mean 25% of the instilled fluid is not drained and dwells in the abdominal cavity. Therefore we evaluated changes of the saline biocompatibility during its dwell in the rats abdominal cavity.
In 10 anesthetized rats normal saline were instilled into the abdominal cavity and samples of the dwelling solution were collected every 30 minutes, for 4 hours. Inflammatory parameters and effect of the collected samples on in vitro cultured rats mesothelial cells were studied.
Low pH of the saline was normalized, but number of cells and % of macrophages and eosinophils, as well as elastase activity and MCP-1 and TGF-β concentration increased, proportionally to the dwell time. Fluid samples tested ex-vivo suppressed proliferation of the mesothelial cells and induced biphasic (stimulation/inhibition) effect on synthesis of MCP-1 in these cells. Similar pattern of release was observed for TF, whereas synthesis of t-PA in the mesothelial cells was strongly suppressed.
Mesothelial cells exposed in vivo to normal saline dwelling in the abdominal cavity acquire properties which may accelerate formation of the peritoneal adhesions.
生理盐水常用于冲洗腹腔，许多外科医生称其对腹膜无害。我们发现，在接受腹腔镜手术的患者中，平均有25%注入的液体未被排出而潴留在腹腔内。因此，我们评估了生理盐水潴留在大鼠腹腔期间其生物相容性的变化。
对10只麻醉大鼠腹腔内注入生理盐水，每30分钟收集一次潴留溶液样本，共收集4小时。研究收集样本的炎症参数及其对体外培养的大鼠间皮细胞的影响。
生理盐水的低pH值恢复正常，但细胞数量、巨噬细胞和嗜酸性粒细胞百分比、弹性蛋白酶活性以及MCP-1和TGF-β浓度均随潴留时间成比例增加。体外测试的液体样本抑制间皮细胞增殖，并对这些细胞中MCP-1的合成产生双相（刺激/抑制）作用。TF的释放模式相似，而间皮细胞中t-PA的合成受到强烈抑制。
体内暴露于潴留在腹腔内的生理盐水的间皮细胞会获得可能加速腹膜粘连形成的特性。
