Effect of chlorhexidine acetate on the early postoperative orthotopic ileal neobladder in situ mucus secretion

Abstract

Objective: To investigate the impact of chlorhexidine acetate's on the mucus secretion function in the early postoperative period of the neo-ileal bladder and compare other treatment agents. Method: 24 patients who underwent total Cystectomy with orthotopic ileal neobladder in our department and divided into three groups (8 each). During the procedure, mucosal treatment agents were infused for five minutes, and specimens were taken for histological examination of the neobladder mucosa under light and electron microscopy.Results: The daily intestinal mucus secretion in the early stage of the neobladder(POD 3-14). Group A (Iodophor) compared to B (anhydrous ethanol), and C (chlorhexidine acetate) were reduced and statistically significant (P <0.05), with no statistical difference between B and C (P> 0.05). Light and Electron microscopy; In group A, the neobladder intestinal mucosa layer is complete; villi were uniformly arranged. A few goblet cells between the apex of the villi disappear an acceptable arrangement of micro-villi and a relatively low degree of organelle damage. In group B, the neobladder intestinal mucosa layer is unclear, the villi arrangement lost and shedding, muscle layer structure disrupted, accompanied by RBC and inflammatory cells infiltration. In group C, neo-bladder intestinal mucosa structure was complete, and villi are low, rupture, shedding, and inflammatory cells infiltrated without significant damage muscle layer.Conclusion: As a new mucous membrane treatment agent, chlorhexidine acetate has a protective effect on the mucous membrane of the new bladder. Meanwhile, it also inhibits the secretion of mucous in the new bladder in the early postoperative period.