Acun Gokce, Ozdemir Hakan, Sunamak Oguzhan, Ozdemir Zehra Unal, Baskan Emel, Yazi Mete, Savas Berna, Berberoglu Ugur
Department of General Surgery, Beypazari Governmental Hospital, Ankara, Turkey.
Department of General Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Rev Invest Clin. 2018;70(6):279-284. doi: 10.24875/RIC.18002589.
Intra-abdominal adhesions and their complications following abdominal surgery are serious problems, with an incidence of 67-93%. Prevention of peritoneal adhesion formation may eliminate the need for surgical intervention, decreasing complications, morbidity, and cost. Bevacizumab is a recombinant monoclonal antibody which specifically binds vascular endothelial growth factor, an important cytokine in adhesion formation, and neutralizes its biological activity. We developed an experimental model in rats to determine the effect of bevacizumab in preventing adhesion formation and analyzed its effect both micro- and macroscopically.
We used 32. Wistar rats randomly divided into two groups: Group A (control) and Group B (bevacizumab), with 16 rats each. A modified cecum abrasion model was developed; 0.9% NaCl solution was administered intraperitoneally to Group A and bevacizumab to Group B. On day 15, adhesion formation was evaluated both macro- and microscopically.
Both micro- and macroscopic adhesion grades in Group B were significantly lower than those of control Group A; macroscopic grades were 2.69 ± 0.95 and 0.69 ± 0.8, and microscopic grades were 2.25 ± 1.06 and 0.5 ± 0.52 for Groups A and B, respectively.
Bevacizumab was effective in preventing intraperitoneal adhesion formation in our study; however, its inhibitory effects on embryogenesis and the hematopoietic, endocrine, and immune systems may limit its clinical use.
腹部手术后腹腔粘连及其并发症是严重问题，发生率为67% - 93%。预防腹膜粘连形成可避免手术干预的需要，减少并发症、发病率和成本。贝伐单抗是一种重组单克隆抗体，它特异性结合血管内皮生长因子（粘连形成中的一种重要细胞因子）并中和其生物活性。我们建立了大鼠实验模型来确定贝伐单抗在预防粘连形成中的作用，并从微观和宏观层面分析其效果。
我们使用32只Wistar大鼠，随机分为两组：A组（对照组）和B组（贝伐单抗组），每组16只。建立改良的盲肠擦伤模型；A组腹腔内注射0.9%氯化钠溶液，B组注射贝伐单抗。在第15天，从宏观和微观层面评估粘连形成情况。
B组的宏观和微观粘连分级均显著低于对照组A组；A组和B组的宏观分级分别为2.69±0.95和0.69±0.8，微观分级分别为2.25±1.06和0.5±0.52。
在我们的研究中，贝伐单抗在预防腹腔粘连形成方面有效；然而，其对胚胎发育以及造血、内分泌和免疫系统的抑制作用可能会限制其临床应用。
