Department of Surgery, The Jikei University Kashiwa Hospital, Chiba, Japan.
Department of Anatomy, The Jikei University School of Medicine, Tokyo, Japan.
J Surg Res. 2019 Feb;234:311-316. doi: 10.1016/j.jss.2018.10.008. Epub 2018 Nov 2.
Postoperative bowel adhesions may lead to various disorders, including abdominal pain, bowel obstruction, ischemia, and necrosis. In previous reports, a dose-dependent increase in bowel adhesions was observed in talc-treated animals in comparison with control animals. Although various methods have been devised to prevent peritoneal adhesions, each of these methods has advantages and disadvantages. In this study, we have attempted to reassess the effect of a carboxymethylcellulose (CMC) solution in the reduction of peritoneal adhesions induced by an intraperitoneal injection of a talc suspension in mice.
Mice received an intraperitoneal injection of a talc suspension, followed by an injection of a CMC solution or vehicle. Two weeks after the injection, any adherent bowel mass was removed en bloc, weighed, and histologically observed.
The administration of talc induced severe bowel adhesions. CMC treatment was unable to completely inhibit the development of bowel adhesions, but treatment did reduce their weight in a dose-dependent manner. According to a histopathologic analysis, the bowel adhesions were composed of a conglomerate of talc aggregate and granulation tissue. The conglomerate was divided into two zones: the cell-rich marginal zone and the cell-scarce central zone. The injection of CMC specifically reduced the width of the marginal zone and the number of infiltrated cells.
This study demonstrated that CMC inhibited bowel adhesions induced by talc in mice. In addition, this is the first report on the effect of CMC on talc peritonitis accompanied by a detailed histologic examination. Our experimental model is very simple and easy to use. Therefore, it may help in the discovery of new antiadhesive agents and in the analysis of the kinetics of bowel adhesion.
术后肠粘连可导致各种疾病，包括腹痛、肠梗阻、缺血和坏死。在之前的报告中，与对照组动物相比，滑石粉处理的动物中观察到肠粘连呈剂量依赖性增加。尽管已经设计了各种方法来预防腹膜粘连，但每种方法都有其优缺点。在这项研究中，我们试图重新评估羧甲基纤维素（CMC）溶液在减少小鼠腹腔内滑石混悬液注射引起的腹膜粘连中的作用。
小鼠接受腹腔内滑石混悬液注射，随后注射 CMC 溶液或载体。注射后 2 周，整块切除任何粘连的肠段，称重，并进行组织学观察。
滑石粉的给药导致严重的肠粘连。CMC 治疗不能完全抑制肠粘连的发展，但治疗能以剂量依赖的方式减轻其重量。根据组织病理学分析，肠粘连由滑石团聚体和肉芽组织的混合物组成。团块分为两个区：富含细胞的边缘区和细胞稀少的中央区。CMC 的注射特异性地减少了边缘区的宽度和浸润细胞的数量。
本研究表明 CMC 抑制了小鼠滑石粉诱导的肠粘连。此外，这是第一个关于 CMC 对伴有详细组织学检查的滑石粉腹膜炎影响的报告。我们的实验模型非常简单易用。因此，它可能有助于发现新的防粘连剂，并分析肠粘连的动力学。
