Comparison of Oral Sirolimus, Prednisolone, and Combination of Both in Experimentally Induced Peritoneal Adhesion

• Published in: The Journal of surgical research 2022-08, Vol.276, p.168-173
• Main Authors: Kazemi, Kourosh, Hosseinzadeh, Ahmad, Shahriarirad, Reza, Nikeghbalian, Saman, Kamran, Hooman, Hosseinpour, Parisa, Tanideh, Nader, Jamshidi, Kamran
• Format: Article
• Language: English
• Subjects: Abdominal Cavity; Adhesion; Animal model; Animals; Disease Models, Animal; Female; Peritoneal Diseases - drug therapy; Peritoneal Diseases - etiology; Peritoneal Diseases - prevention & control; Postoperative Complications - prevention & control; Prednisolone; Rapamycin; Rats; Sirolimus; Sirolimus - therapeutic use; Tissue Adhesions - complications; Tissue Adhesions - prevention & control
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2022.02.047

Peritoneal adhesion formation is a challenging postoperative complication. We aim to evaluate the effect of orally administered sirolimus, prednisolone, and their combination to prevent this entity. Eighty female albino underwent intraperitoneal injection of 3 mL of 10% sterile talc solution to induce peritoneal adhesion, and were subsequently and randomly divided into four groups (each n = 20); including a control group; 1 mg/kg oral prednisolone daily in the morning; 0.1 mg/kg oral sirolimus daily; and a combination group which received both drugs, with the same dosage. On the 29th day, abdominal cavities were explored, and classification was done based on Nair classification. All rats were healthy on the 29th day, in which exploration was performed. The rats in the control group had extensive intra-abdominal adhesions, while 17 (85%) rats in the control group had substantial adhesion; however, the prednisolone, sirolimus, and combination group had lesser adhesion formation. Also, 14 (70%) rats of prednisolone group, 13 (65%) of sirolimus group, and 16 (80%) of combination group had insubstantial adhesion. The decrease in the grade of peritoneal adhesion bands was highly significant in the combination group (P > 0.001). The combination of sirolimus and prednisolone was effective for preventing peritoneal adhesions in rats.