The Role of Simvastatin on Postoperative Peritoneal Adhesion Formation in an Animal Model

Abstract

Aim: The aim of this study is to show the effect of simvastatin on intra-abdominal adhesion formation. Method: Adhesion formation was achieved by scratching the cecum and anterior abdominal wall following median laparotomy. Three different groups of 10 rats each were formed. In group I, 0.57 mg/kg/day simvastatin was injected intraperitoneally right after the operation and for 5 days thereafter. In group II, an equal dose of simvastatin to that used in group I was given via gavage. A physiological saline solution was given to group III for the same period of time. On the 6th and 14th day, blood samples were taken and peritoneal lavage was performed to measure the tissue-type plasminogen activator (t-PA) activity. Adhesions were graded via re-laparotomies on the 14th day after the first operation. Results: The adhesion scores were 1.40 ± 0.22, 1.50 ± 0.26, and 2.90 ± 0.34 in groups I, II, and III, respectively (p = 0.007), and the score was higher in group III than in the other groups (p = 0.005, p = 0.011). Conclusion: Intraperitoneal simvastatin application decreases adhesion formation by increasing the t-PA level in abdominal surgery.

An FDA Approved Neurokinin-1 Receptor Antagonist is Effective in Reducing Intraabdominal Adhesions when Administered Intraperitoneally, But Not Orally

“…Such drugs include the NK-1RA CJ-12,255, methylene blue, atorvastatin, pentoxifylline, and octreotide. 18,[21][22][23][24][25][26][27][28][29][30] Studies in both humans and animals demonstrate the ability of the peritoneal fibrinolytic system to regulate adhesion formation. Patients with the most severe adhesions have decreased postoperative tPA activity as well as increased levels of PAI-1.…”

Separately and synergistic effects of taurolidine and icodextrin in preventing intraabdominal adhesions

“…[14,15] Several pharmacological agents, such as high doses of vitamin E and simvastatin, were discovered to have a high efficacy in adhesion prevention. [16][17][18] Taurolidine is an antimicrobial agent used for intra-abdominal adhesion formation and sepsis prevention in experimental and clinical trials. In previous studies, the blocking effects of taurolidine on fibrin deposition have been described.…”

Prevention of Abdominal Adhesions – Present State and What’s beyond the Horizon?

“…Hormone modulation as a mode of reducing adhesions via induction of hypoestrogenism has also been tried [51] . Simvastatin intraperitoneally has also shown experimental reduction in adhesion formation via induction of t-PA activity [52] .…”