Srinivasan Pramod Kadaba, Sperber Vera, Afify Mamdouh, Tanaka Hirokazu, Fukushima Kenji, Kögel Babette, Gremse Felix, Tolba René
Institute for Laboratory Animal Science and Experimental Surgery, University Hospital, RWTH Aachen, 52074 Aachen, Germany.
Experimental Molecular Imaging, University Hospital, RWTH Aachen, 52074 Aachen, Germany.
World J Hepatol. 2017 Aug 28;9(24):1030-1039. doi: 10.4254/wjh.v9.i24.1030.
To compare a novel, fully synthetic, polyurethane based glue (MAR-1) to fibrin sealant in a partial liver resection rat model.
After 50% resection of the lateral left liver lobe in male Wistar rats ( = 7/group/time point), MAR-1, Fibrin or NaCl was applied. After 14, 21 and 90 postoperative days, sealant degradation, intra-abdominal adhesions were scored, and histological examination of liver tissue was performed.
(Mean ± SEM) (MAR-1 Fibrin NaCl). Bleeding mass was significantly higher in NaCl (3.36 ± 0.51 g) compared to MAR-1 (1.44 ± 0.40 g) and Fibrin (1.16 ± 0.32 g). At 14 and 90 d, bleeding time was significantly lower in MAR-1 (6.00 ± 0.9 s; 13.57 ± 3.22 s) and Fibrin (3.00 ± 0.44 s; 22.2 ± 9.75 s) compared to NaCl (158.16 ± 11.36 s; 127.5 ± 23.3 s). ALT levels were significantly higher in MAR-1 (27.66 ± 1 U/L) compared to Fibrin (24.16 ± 0.98 U/L) and NaCl (23.85 ± 0.80 U/L). Intrabdominal adhesions were significantly lower in MAR-1 (11.22% ± 5.5%) compared to NaCl (58.57% ± 11.83%). Degradation of the glue was observed and MAR-1 showed almost no traces of glue in the abdominal cavity as compared to the Fibrin (10% ± 5% 14 d; 7% ± 3% 21 d). Survival showed no significant differences between the groups.
Compared to Fibrin, MAR-1 showed similar hemostatic properties, no adverse effects, and is biocompatible. Further studies on adhesion strength and biodegradability of synthetic sealants are warranted.
在大鼠部分肝切除模型中,比较一种新型的、完全合成的聚氨酯基胶水(MAR-1)与纤维蛋白密封剂。
在雄性Wistar大鼠(每组7只/每个时间点)左侧肝叶外侧50%切除后,应用MAR-1、纤维蛋白或氯化钠。术后14、21和90天,对密封剂降解、腹腔粘连情况进行评分,并对肝组织进行组织学检查。
(均值±标准误)(MAR-1 纤维蛋白 氯化钠)。与MAR-1(1.44±0.40克)和纤维蛋白(1.16±0.32克)相比,氯化钠组的出血量(3.36±0.51克)显著更高。在第14天和90天时,与氯化钠组(158.16±11.36秒;127.5±23.3秒)相比,MAR-1组(6.00±0.9秒;13.57±3.22秒)和纤维蛋白组(3.00±0.44秒;22.2±9.75秒)的出血时间显著更短。与纤维蛋白组(24.16±0.98 U/L)和氯化钠组(23.85±0.80 U/L)相比,MAR-1组的谷丙转氨酶(ALT)水平显著更高(27.66±1 U/L)。与氯化钠组(58.57%±11.83%)相比,MAR-1组的腹腔粘连显著更少(11.22%±5.5%)。观察到胶水有降解情况,与纤维蛋白相比,MAR-1在腹腔内几乎没有胶水残留痕迹(第14天为10%±5%;第21天为7%±3%)。各组间生存率无显著差异。
与纤维蛋白相比,MAR-1具有相似的止血性能,无不良反应,且具有生物相容性。有必要对合成密封剂的粘附强度和生物降解性进行进一步研究。