Perioperative Lavage Promotes Intraperitoneal Adhesion in the Rat

Westreenen, Mireille van; Tol, P.M. van den; Pronk, Apollo; Marquet, R. L.; Jeekel, J.; Leguit, P

doi:10.1159/000008639

Cited by 36 publications

(38 citation statements)

References 12 publications

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“…When saline lavage or installation is included into the experimental groups, three different results are observed; beneficial, [10][11][12][13][14] ineffective, [9,[15][16][17][18] or even harmful. [19,20] Another challenge in peritoneal adhesion studies is the use of several different models. Two major problems caused by peritoneal adhesions are intestinal obstruction and infertility.…”

Section: Discussionmentioning

confidence: 99%

“…[20] van Westreenen et al have also suggested stimulation of intraperitoneal adhesions with perioperative lavage. [19] In this rat study, uterine horns were attached to the suture placed lateral to the wall of the abdomen, and 10 ml of lavage (25 °C) for 10 min was applied. The lavage solutions were normal saline, povidone-iodine 1%, chlorhexidine 0.02%, RPMI growth (cell culture) medium, and UW (University of Wisconsin solution).…”

Section: Discussionmentioning

confidence: 99%

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Effects of saline lavage temperature on peritoneal fibrinolysis and adhesion formation

Koca

Tarhan

Kaya

et al. 2015

Ulus Travma Acil Cerrahi Derg

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of saline lavage temperature on peritoneal fibrinolysis and adhesion formation

Koca

Tarhan

Kaya

et al. 2015

Ulus Travma Acil Cerrahi Derg

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show abstract

“…Early studies on this issue proved that use of peritoneal lavage was associated with a greater incidence of adhesions than in cases without lavage, and this was repetitively observed with various fluids (10,11). Peritoneal reactions to injected substances, including different solutions, have not been thoroughly investigated.…”

Section: Discussionmentioning

confidence: 99%

Effects of Saline and Other Peritoneal Lavage Solutions on the Morphology and Function of in Vitro Mesothelial Cells

Winckiewicz¹,

Połubińska²,

Staniszewski³

et al. 2007

Polish Journal of Surgery

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The aim of the study was to evaluate the effects of 0.9% NaCl and other solutions suitable for peritoneal lavage on in vitro viability and fibrinolytic activity of human peritoneal mesothelial cells. Material and methods. Mesothelial cells were isolated from the intra-operatively collected greater omentum specimens and then cultured. Subsequently, eight cultures (n=8) were incubated for six hours with M199 culture medium (control group) or culture medium with the addition of 0.9% NaCl, PD fluid Gambrosol-Trio 10 or Hanks' solution. Immediately after exposure to the studied solutions, the amount of LDH released by the cultured cells was determined. Then, cultured cells were incubated for the next 24 hours; after this period their metabolism and fibrinolytic activity were determined by means of IL-6, t-PA and PAI-1 levels. Levels of these substances were compared to the amount of total cellular protein that was determined simultaneously. Results. Hanks' solution showed no significant influence on cellular culture architecture and mesothelium metabolism. PD fluid Gambrosol-Trio 10 damaged mesothelial cell structure and function as manifested by an increased release of LDH and enhanced t-PA synthesis, as well as decreased production of IL-6 and PAI-1. Exposure to 0.9% NaCl solution was found to cause a disturbance in cellular adhesion without significant structural damage (marked changes in cellular morphology without increased LDH release) and significant metabolism impairment as presented by reduced production of t-PA, IL-6 and PAI-1. Conclusions. Saline solution and PD fluids should not be used for peritoneal lavage. Further investigations are required to identify the least harmful solution for mesothelial cells suitable for application in intra-operative peritoneal lavage.

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“…Therefore, we decided to investigate the efficacy of PL in adhesion prevention in the presence of abdominal drainages. Since there is experimental and clinical evidence that crystalloids result in enhanced adhesion formation, we left the matching groups without additional therapy [32,33].…”

Section: Discussionmentioning

confidence: 99%

Effects of Intra-Abdominal Drainages on Adhesion Formation and Prevention by Phospholipids in a Rat Model

Bertram¹,

Treutner²,

Tietze³

et al. 2003

Eur Surg Res

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Background and Aims: The study was designed to asses the adhesiogenic capacity of silicone drainages and the protective effect of phospholipids (PL). Materials and Methods: A total of 75 Wistar rats were randomly assigned to the different groups. In a preliminary trial (pt; n = 15), all rats underwent midline laparotomy. The control group (C_pt; n = 5) received no further treatment. In the other animals, either an ‘easy flow’ drainage (EF_pt; n = 5) or an ‘Aachen’ drainage (AC_pt; n = 5) was placed into the abdominal cavity. In the final study (fs; n = 60), rats underwent laparotomy and colonic anastomosis. The control groups (C_fs) received no drainages. In the other groups either one of the two types of drainages (EF_fs, AC_fs) were introduced. In 50% of the rats, 75 mg/kg of PL were administered intraperitoneally (C_fs+PL, EF_fs+PL, AC_fs+PL). The other rats received no additional treatment (C_fsØPL, EF_fsØPL, AC_fsØPL). All animals were sacrificed 10 days after surgery. Areas of adhesions and anastomotic bursting pressures were measured (mean ± SD). Results: In the preliminary trial, analysis of variance (ANOVA) revealed no differences between the groups after application of drainages (values are given in mean ± SD): C_pt mean 23.3 ± 29.4 mm², EF_pt 829.7 ± 679.3 mm², AC_pt 609.9 ± 219.4 mm². In the final study, 2-factorial ANOVA showed a significant effect (p < 0.001) for the use of drainages but not for the application of PL (C_fsØPL 140.6 ± 124.2 mm², C_fs+PL 67.7 ± 60.4 mm², EF_fsØPL 1,217.0 ± 458.3 mm², EF_fs+PL 1,266.8 ± 368.3 mm², AC_fsØPL 861.7 ± 274.8 mm², AC_fs+PL 544.2 ± 193.8 mm²). Post hoc test for pairwise comparisons adjusted to Bonferroni showed significant differences (p < 0.001) between all of the three pairs (C_fs 104.1 ± 92.3 mm² vs. EF_fs 1,241.9 mm² ± 413.3 mm²; C_fs vs. AC_fs 702.9 mm ± 234.3 mm²; EF_fs vs. AC_fs). Discussion: The final study demonstrates the adhesiogenic capacity of silicone drainage tubes in combination with anastomoses. Any protective effect of PL alone or in combination with drainages could not be shown. Conclusions: Indication for the use of drainages in standard surgical procedures should be reconsidered within the scope of their potential to cause adhesions and subsequent complications.

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Perioperative Lavage Promotes Intraperitoneal Adhesion in the Rat

Cited by 36 publications

References 12 publications

Effects of saline lavage temperature on peritoneal fibrinolysis and adhesion formation

Effects of saline lavage temperature on peritoneal fibrinolysis and adhesion formation

Effects of Saline and Other Peritoneal Lavage Solutions on the Morphology and Function of in Vitro Mesothelial Cells

Effects of Intra-Abdominal Drainages on Adhesion Formation and Prevention by Phospholipids in a Rat Model

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