Araştırma Makalesi
Ameliyat sonrası karın içi yapışıklıkların önlenmesinde Taurolin, Seprafilm ve Mesofolun etkinliklerinin karşılaştırlması
Öz
Amaç: Yapışıklık hala genel cerrahinin önemli sorunlarından biri olmaya devam etmekte olup; tedavide fikir birliği oluşmamıştır. Çalışmanın amacı daha önce pek çok çalışmada kullanılan Seprafilm ile bağırsak yapışıklığı konusunda bildiğimiz kadarı ile kullanılmayan Mezofolün ve hakkında farklı görüşler bulunan Taurolidin etkinliklerini araştırmak ve karşılaştırmaktır.
Gereç ve Yöntemler: Otuz adet Wistar-Albino erkek sıçan kullanılarak 5 grup oluşturuldu. Çekal abrasyon sonrası grup 1’de ek işlem yapılmadan karın kapatıldı (sham), grup 2’de karın içerisine 2 ml serum fizyolojik verildi, grup 3’te karın içerisine 2 ml Taurolidin %2 verildi, grup 4’e karın duvarı altına 2x2 cm’lik Mesofol uygulandı, grup 5’te karın duvarı altına 2x2 cm’lik Seprafilm uygulandı. Yapışıklıklar; Nair sınıflaması, yapışıklıkların şiddetine göre derecelendirme, tulan alanın yaygınlığına göre tanımlanmış derecelendirme sistemleri olmak üzere üç farklı derecelendirme sistemi kullanılarak değerlendirilmiştir.
Bulgular: Tüm sınıflama sistemlerine göre Mesofol ve Seprafilm karın içi yapışıklıkları önlemede etkili bulunmuştur. Seprafilm ile Mesofol arasında istatistiki olarak anlamlı bir fark yoktur.
Sonuç: Mesofol ve Seprafilm kullanımı ile karın içi yapışıklıklarda istatistiki olarak anlamlı azalma tespit edilmiştir. Mesofolün karın içi yapışıklıkların önlenmesi amacı ile kullanılabilecek bir ajan olduğunu düşündürmekle birlikte; daha çok çalışma yapılması gerekmektedir.
Anahtar Kelimeler
Destekleyen Kurum
yok
Kaynakça
- 1. Grant HW, Parker MC, Wilson MS, Menzies D, Sunderland G, Thompson JN, et al. Adhesions after abdominal surgery in children. J Pediatr Surg. 2008;43(1):152-7.
- 2. Tingstedt B, Isaksson K, Andersson E, Andersson R. Prevention of abdominal adhesions--present state and what's beyond the horizon? Eur Surg Res. 2007;39(5):259-68.
- 3. Altuntas YE, Kement M, Oncel M, Sahip Y, Kaptanoglu L. The effectiveness of hyaluronan-carboxymethylcellulose membrane in different severity of adhesions observed at the time of relaparotomies: an experimental study on mice. Dis Colon Rectum. 2008;51(10):1562-5.
- 4. Tingstedt B, Isaksson J, Andersson R. Long-term follow-up and cost analysis following surgery for small bowel obstruction caused by intra-abdominal adhesions. Br J Surg. 2007;94(6):743-8.
- 5. Menzies D, Ellis H. Intestinal obstruction from adhesions--how big is the problem? Ann R Coll Surg Engl. 1990;72(1):60-3.
- 6. Attard J-AP, MacLean AR. Adhesive small bowel obstruction: epidemiology, biology and prevention. Can J Surg. 2007;50(4):291-300.
- 7. van Goor H. Consequences and complications of peritoneal adhesions. Colorectal Dis. 2007;9 Suppl 2:25-34.
- 8. Tsuji S, Takahashi K, Yomo H, Fujiwara M, Kita N, Takebayashi K, et al. Effectiveness of antiadhesion barriers in preventing adhesion after myomectomy in patients with uterine leiomyoma. Eur J Obstet Gynecol Reprod Biol. 2005;123(2):244-8.
- 9. Chegini N, Kotseos K, Zhao Y, Bennett B, McLean FW, Diamond MP, et al. Differential expression of TGF-beta1 and TGF-beta3 in serosal tissues of human intraperitoneal organs and peritoneal adhesions. Hum Reprod. 2001;16(6):1291-300.
- 10. Lower AM, Hawthorn RJ, Clark D, Boyd JH, Finlayson AR, Knight AD, et al. Adhesion-related readmissions following gynaecological laparoscopy or laparotomy in Scotland: an epidemiological study of 24 046 patients. Hum Reprod. 2004;19(8):1877-85.
- 11. Kaptanoglu L, Kucuk HF, Yegenoglu A, Uzun H, Eser M, Mentes CV, et al. Effects of seprafilm and heparin in combination on intra-abdominal adhesions. Eur Surg Res. 2008;41(2):203-7.
- 12. Tarhan OR, Barut I, Sezik M. An evaluation of normal saline and taurolidine on intra-abdominal adhesion formation and peritoneal fibrinolysis. J Surg Res. 2008;144(1):151-7.
- 13. Demirbag S, Cetinkursun S, Tasdemir U, Ozturk H, Pekcan M, Yesildaglar N. Comparison of hyaluronate/carboxymethylcellulose membrane and melatonin for prevention of adhesion formation in a rat model. Hum Reprod. 2005;20(7):2021-4.
- 14. Cheong YC, Laird SM, Li TC, Shelton JB, Ledger WL, Cooke ID. Peritoneal healing and adhesion formation/reformation. Hum Reprod Update. 2001;7(6):556-66.
- 15. Ersoy E, Ozturk V, Yazgan A, Ozdogan M, Gundogdu H. Comparison of the two types of bioresorbable barriers to prevent intra-abdominal adhesions in rats. J Gastrointest Surg. 2009;13(2):282-6.
- 16. Ersoy E, Ozturk V, Yazgan A, Ozdogan M, Gundogdu H. Effect of polylactic acid film barrier on intra-abdominal adhesion formation. J Surg Res. 2008;147(1):148-52.
- 17. Demirturk F, Aytan H, Caliskan AC. Comparison of the adhesion scoring systems used in animal models and assessment of interobserver reproducibility. The Australian & New Zealand journal of obstetrics & gynaecology. 2006;46(4):356-9.
- 18. Kucuk HF, Kaptanoglu L, Kurt N, Uzun H, Eser M, Bingul S, et al. The role of simvastatin on postoperative peritoneal adhesion formation in an animal model. Eur Surg Res. 2007;39(2):98-102.
- 19. Nair SK, Bhat IK, Aurora AL. Role of proteolytic enzyme in the prevention of postoperative intraperitoneal adhesions. Arch Surg. 1974;108(6):849-53.
- 20. Granat M, Tur-Kaspa I, Zylber-Katz E, Schenker JG. Reduction of peritoneal adhesion formation by colchicine: a comparative study in the rat. Fertil Steril. 1983;40(3):369-72.
- 21. Improvement of interobserver reproducibility of adhesion scoring systems. Adhesion Scoring Group. Fertil Steril. 1994;62(5):984-8.
- 22. Treutner KH, Bertram P, Lerch MM, Klimaszewski M, Petrovic-Källholm S, Sobesky J, et al. Prevention of postoperative adhesions by single intraperitoneal medication. J Surg Res. 1995;59(6):764-71.
- 23. Bahadir I, Oncel M, Kement M, Sahip Y. Intra-abdominal use of taurolidine or heparin as alternative products to an antiadhesive barrier (Seprafilm) in adhesion prevention: an experimental study on mice. Dis Colon Rectum. 2007;50(12):2209-14.
- 24. Opitz I, van der Veen HC, Braumann C, Ablassmaier B, Führer K, Jacobi CA. The influence of adhesion prophylactic substances and taurolidine/heparin on local recurrence and intraperitoneal tumor growth after laparoscopic-assisted bowel resection of colon carcinoma in a rat model. Surg Endosc. 2003;17(7):1098-104.
- 25. Muller SA, Treutner KH, Jorn H, Anurov M, Oettinger AP, Schumpelick V. Adhesion prevention comparing liquid and solid barriers in the rabbit uterine horn model. Eur J Obstet Gynecol Reprod Biol. 2005;120(2):222-6.
- 26. Klopp LS, Simon BJ, Bush JM, Enns RM, Turner AS. Comparison of a caprolactone/lactide film (mesofol) to two polylactide film products as a barrier to postoperative peridural adhesion in an ovine dorsal laminectomy model. Spine (Phila Pa 1976). 2008;33(14):1518-26.
- 27. Pelosi MA, 2nd, Pelosi MA, 3rd. A new nonabsorbable adhesion barrier for myomectomy. American journal of surgery. 2002;184(5):428-32.
- 28. Wallwiener D, Meyer A, Bastert G. Adhesion formation of the parietal and visceral peritoneum: an explanation for the controversy on the use of autologous and alloplastic barriers? Fertil Steril. 1998;69(1):132-7.
- 29. Yoldemir T, Sagol S, Adakan S, Oztekin K, Ozsener S, Karadadas N. Comparison of the reduction of postoperative adhesions by two barriers, one solution, and two pharmacologic agents in the rat uterine model. Fertil Steril. 2002;78(2):335-9.
- 30. Ergul E, Korukluoglu B. Peritoneal adhesions: facing the enemy. Int J Surg. 2008;6(3):253-60.
Yıl 2020,
Cilt: 4 Sayı: 3, 30 - 38, 27.11.2020
Öz
Aim: Intraabdominal adhesions continue being a major problem of general surgery, there is no consensus for the treatment. Our aim in this study was to asses and compare the effects of Seprafilm which is often studied with Mesofol which to the best of our knowledge has not been studied in intraabdominal adhesions and Taurolin for which there exists no consensus.
Materials and Methods: Thirty male Wistar albino rats were divided into 5 groups. After cecal abrasion; in group;1 no intervention was made (sham), in group 2; 2 ml of saline, in group 3; 2 ml Taurolin %2 was added, in group 4; 2x2 cm Mesofol was inserted beneath the abdominal wall, in group 5; 2x2 cm of Seprafilm was inserted beneath the abdominal wall, Adhesions were evaluated using three different classification systems. Nair classification, grading according to the severity of adhesions classification, and grading according to the affected area classification.
Results: Mesofol and Seprafilm were both effective in decreasing intraabdominal adhesions in all classification systems. There is no statistical difference between Mesofol and Seprafilm.
Conclusion: Statistically significance in decreasing intra-abdominal adhesions was obtained with both Mesofol and Seprafilm. While Mesofol can be proposed as an agent to degrease intraabdominal adhesions more studies are required
Anahtar Kelimeler
Kaynakça
- 1. Grant HW, Parker MC, Wilson MS, Menzies D, Sunderland G, Thompson JN, et al. Adhesions after abdominal surgery in children. J Pediatr Surg. 2008;43(1):152-7.
- 2. Tingstedt B, Isaksson K, Andersson E, Andersson R. Prevention of abdominal adhesions--present state and what's beyond the horizon? Eur Surg Res. 2007;39(5):259-68.
- 3. Altuntas YE, Kement M, Oncel M, Sahip Y, Kaptanoglu L. The effectiveness of hyaluronan-carboxymethylcellulose membrane in different severity of adhesions observed at the time of relaparotomies: an experimental study on mice. Dis Colon Rectum. 2008;51(10):1562-5.
- 4. Tingstedt B, Isaksson J, Andersson R. Long-term follow-up and cost analysis following surgery for small bowel obstruction caused by intra-abdominal adhesions. Br J Surg. 2007;94(6):743-8.
- 5. Menzies D, Ellis H. Intestinal obstruction from adhesions--how big is the problem? Ann R Coll Surg Engl. 1990;72(1):60-3.
- 6. Attard J-AP, MacLean AR. Adhesive small bowel obstruction: epidemiology, biology and prevention. Can J Surg. 2007;50(4):291-300.
- 7. van Goor H. Consequences and complications of peritoneal adhesions. Colorectal Dis. 2007;9 Suppl 2:25-34.
- 8. Tsuji S, Takahashi K, Yomo H, Fujiwara M, Kita N, Takebayashi K, et al. Effectiveness of antiadhesion barriers in preventing adhesion after myomectomy in patients with uterine leiomyoma. Eur J Obstet Gynecol Reprod Biol. 2005;123(2):244-8.
- 9. Chegini N, Kotseos K, Zhao Y, Bennett B, McLean FW, Diamond MP, et al. Differential expression of TGF-beta1 and TGF-beta3 in serosal tissues of human intraperitoneal organs and peritoneal adhesions. Hum Reprod. 2001;16(6):1291-300.
- 10. Lower AM, Hawthorn RJ, Clark D, Boyd JH, Finlayson AR, Knight AD, et al. Adhesion-related readmissions following gynaecological laparoscopy or laparotomy in Scotland: an epidemiological study of 24 046 patients. Hum Reprod. 2004;19(8):1877-85.
- 11. Kaptanoglu L, Kucuk HF, Yegenoglu A, Uzun H, Eser M, Mentes CV, et al. Effects of seprafilm and heparin in combination on intra-abdominal adhesions. Eur Surg Res. 2008;41(2):203-7.
- 12. Tarhan OR, Barut I, Sezik M. An evaluation of normal saline and taurolidine on intra-abdominal adhesion formation and peritoneal fibrinolysis. J Surg Res. 2008;144(1):151-7.
- 13. Demirbag S, Cetinkursun S, Tasdemir U, Ozturk H, Pekcan M, Yesildaglar N. Comparison of hyaluronate/carboxymethylcellulose membrane and melatonin for prevention of adhesion formation in a rat model. Hum Reprod. 2005;20(7):2021-4.
- 14. Cheong YC, Laird SM, Li TC, Shelton JB, Ledger WL, Cooke ID. Peritoneal healing and adhesion formation/reformation. Hum Reprod Update. 2001;7(6):556-66.
- 15. Ersoy E, Ozturk V, Yazgan A, Ozdogan M, Gundogdu H. Comparison of the two types of bioresorbable barriers to prevent intra-abdominal adhesions in rats. J Gastrointest Surg. 2009;13(2):282-6.
- 16. Ersoy E, Ozturk V, Yazgan A, Ozdogan M, Gundogdu H. Effect of polylactic acid film barrier on intra-abdominal adhesion formation. J Surg Res. 2008;147(1):148-52.
- 17. Demirturk F, Aytan H, Caliskan AC. Comparison of the adhesion scoring systems used in animal models and assessment of interobserver reproducibility. The Australian & New Zealand journal of obstetrics & gynaecology. 2006;46(4):356-9.
- 18. Kucuk HF, Kaptanoglu L, Kurt N, Uzun H, Eser M, Bingul S, et al. The role of simvastatin on postoperative peritoneal adhesion formation in an animal model. Eur Surg Res. 2007;39(2):98-102.
- 19. Nair SK, Bhat IK, Aurora AL. Role of proteolytic enzyme in the prevention of postoperative intraperitoneal adhesions. Arch Surg. 1974;108(6):849-53.
- 20. Granat M, Tur-Kaspa I, Zylber-Katz E, Schenker JG. Reduction of peritoneal adhesion formation by colchicine: a comparative study in the rat. Fertil Steril. 1983;40(3):369-72.
- 21. Improvement of interobserver reproducibility of adhesion scoring systems. Adhesion Scoring Group. Fertil Steril. 1994;62(5):984-8.
- 22. Treutner KH, Bertram P, Lerch MM, Klimaszewski M, Petrovic-Källholm S, Sobesky J, et al. Prevention of postoperative adhesions by single intraperitoneal medication. J Surg Res. 1995;59(6):764-71.
- 23. Bahadir I, Oncel M, Kement M, Sahip Y. Intra-abdominal use of taurolidine or heparin as alternative products to an antiadhesive barrier (Seprafilm) in adhesion prevention: an experimental study on mice. Dis Colon Rectum. 2007;50(12):2209-14.
- 24. Opitz I, van der Veen HC, Braumann C, Ablassmaier B, Führer K, Jacobi CA. The influence of adhesion prophylactic substances and taurolidine/heparin on local recurrence and intraperitoneal tumor growth after laparoscopic-assisted bowel resection of colon carcinoma in a rat model. Surg Endosc. 2003;17(7):1098-104.
- 25. Muller SA, Treutner KH, Jorn H, Anurov M, Oettinger AP, Schumpelick V. Adhesion prevention comparing liquid and solid barriers in the rabbit uterine horn model. Eur J Obstet Gynecol Reprod Biol. 2005;120(2):222-6.
- 26. Klopp LS, Simon BJ, Bush JM, Enns RM, Turner AS. Comparison of a caprolactone/lactide film (mesofol) to two polylactide film products as a barrier to postoperative peridural adhesion in an ovine dorsal laminectomy model. Spine (Phila Pa 1976). 2008;33(14):1518-26.
- 27. Pelosi MA, 2nd, Pelosi MA, 3rd. A new nonabsorbable adhesion barrier for myomectomy. American journal of surgery. 2002;184(5):428-32.
- 28. Wallwiener D, Meyer A, Bastert G. Adhesion formation of the parietal and visceral peritoneum: an explanation for the controversy on the use of autologous and alloplastic barriers? Fertil Steril. 1998;69(1):132-7.
- 29. Yoldemir T, Sagol S, Adakan S, Oztekin K, Ozsener S, Karadadas N. Comparison of the reduction of postoperative adhesions by two barriers, one solution, and two pharmacologic agents in the rat uterine model. Fertil Steril. 2002;78(2):335-9.
- 30. Ergul E, Korukluoglu B. Peritoneal adhesions: facing the enemy. Int J Surg. 2008;6(3):253-60.
Toplam 30 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | MAKALELER |
| Yazarlar | |
| Yayımlanma Tarihi | 27 Kasım 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 4 Sayı: 3 |
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