Barambio Javier, García-Arranz Mariano, Villarejo Campos Pedro, Vélez Pinto Juan Felipe, Clemente Luz Vega, Gómez-Heras Soledad García, Guadalajara Héctor, García-Olmo Damián
Fundación Jiménez Díaz University Hospital, 28033 Madrid, Spain.
Department of Surgery, Faculty of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain.
Biology (Basel). 2022 Aug 2;11(8):1159. doi: 10.3390/biology11081159.
(1) Background: Abdominal adhesions are a common disease appearing after any type of abdominal surgery and may prolong surgical time and cause intestinal obstruction, infertility, or chronic pain. We propose the use of intraperitoneal collagenase to perform chemical adhesiolysis based on the pathophysiology and histology of adhesions. (2) Methods: We generated an adhesion model with intraperitoneal polypropylene meshes. Four months later, we evaluated the efficacy of the treatment in blinded form, i.e., 0.05% collagenase vs. placebo at 37 °C for 20 min. Protocol 1: Ten rats with ten mesh fragments, in which an attempt was made to remove the maximum number of meshes in a 5-min period. Protocol 2: Six rats with four mesh fragments in the sides of the abdominal cavity in which adhesiolysis was performed using a device that measures burst pressure. (3) Results: Protocol 1: 42% efficacy in the collagenase group versus 8% in the control group (p < 0.013). Protocol 2: 188.25 mmHg (SD 69.65) in the collagenase group vs. 325.76 mmHg (SD 50.25) in the control group (p < 0.001). (4) Conclusions: Collagenase allows for the safe and effective chemical adhesiolysis in this experimental model of adhesions.
(1)背景：腹部粘连是任何类型腹部手术后常见的疾病，可能会延长手术时间并导致肠梗阻、不孕或慢性疼痛。基于粘连的病理生理学和组织学，我们建议使用腹腔内胶原酶进行化学粘连松解术。(2)方法：我们用腹腔内聚丙烯网片建立了粘连模型。四个月后，我们以盲法评估治疗效果，即在37℃下用0.05%胶原酶与安慰剂处理20分钟。方案1：十只大鼠，每只大鼠有十个网片碎片，尝试在5分钟内尽可能多地移除网片。方案2：六只大鼠，腹腔两侧各有四个网片碎片，使用测量破裂压力的装置进行粘连松解术。(3)结果：方案1：胶原酶组有效率为42%，而对照组为8%（p<0.013）。方案2：胶原酶组为188.25 mmHg（标准差69.65），对照组为325.76 mmHg（标准差50.25）（p<0.001）。(4)结论：在这个粘连实验模型中，胶原酶可实现安全有效的化学粘连松解术。
