Histological Analysis of Intra-Abdominal Adhesions Treated with Sodium Hyaluronate and Carboxymethylcellulose Gel.

Autor: Montalvo-Javé EE; a Departamento de Cirugía, Facultad de Medicina , Universidad Nacional Autónoma de México , México D.F. , México.; b Servicio de Cirugía General , Unidad 304, Hospital General de México , SSA , México., Mendoza-Barrera GE; a Departamento de Cirugía, Facultad de Medicina , Universidad Nacional Autónoma de México , México D.F. , México., García-Pineda MA; a Departamento de Cirugía, Facultad de Medicina , Universidad Nacional Autónoma de México , México D.F. , México., Jaime Limón ÁR; a Departamento de Cirugía, Facultad de Medicina , Universidad Nacional Autónoma de México , México D.F. , México., Montalvo-Arenas C; c Departamento de Biología Celular y Tisular, Facultad de Medicina , Universidad Nacional Autónoma de México , México D.F. , México., Castell Rodríguez AE; c Departamento de Biología Celular y Tisular, Facultad de Medicina , Universidad Nacional Autónoma de México , México D.F. , México., Tapia Jurado J; a Departamento de Cirugía, Facultad de Medicina , Universidad Nacional Autónoma de México , México D.F. , México.
Jazyk: angličtina
Zdroj: Journal of investigative surgery : the official journal of the Academy of Surgical Research [J Invest Surg] 2016; Vol. 29 (2), pp. 80-7. Date of Electronic Publication: 2015 Sep 16.
DOI: 10.3109/08941939.2015.1076911
Abstrakt: Purpose: To evaluate macro and microscopically the adhesions developed after using the anti-adherence compound sodium hyaluronate and carboxymethylcellulose (SH-CBMC) gel and to determine the volume of the adhesions using a stereological estimation.
Methods: The study was experimental, random, comparative, and prospective. The subjects of the study were male Wistar rats divided in three groups (n = 10). Group I (control) included rats with no peritoneal injury. Group II rats had a 2 cm diameter injury created bilaterally in the parietal peritoneum at 3 cm from the abdominal midline with electrocautery coated with physiological solution. Group III rats were given the same injuries and coated with SH-CBMC gel. All groups were followed up postoperatively for 30 days, after which a laparotomy was performed to macroscopically determine the presence and type of adhesions. Experimental models were euthanized with anesthetic overdose and biopsies were taken for histopathological examination and stereological estimate of the volume of adhesions.
Results: Macroscopic adhesions were 20% less prevalent in Group III compared to Group II, which presented 40% more multiple and firm adhesions, unlike in Group III, in which they were unique and lax. There was a statistically significant decrease in the presence and number of adhesions in rats treated with SH-CBMC gel. Inflammatory infiltrate was significantly lower in rats treated with SH-CBMC gel, but there were no differences in connective tissue, fibrosis, and angiogenesis among groups. There was no statistical difference in the overall volume of adhesions among the treatment groups.
Conclusions: SH-CBMC gel reduces macroscopic presence and number of adhesions and the severity of the inflammatory infiltrate.
Databáze: MEDLINE
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