Experimental evaluation of phospholipids and icodextrin in re-formation of peritoneal adhesions

Background: The formation of further adhesions after adhesiolysis is a major problem. Not all agents that are supposed to reduce de novo adhesions can reduce further adhesion formation. The efficacy and safety of intraperitoneally applied phospholipids has been shown previously. This study evaluated...

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Published in:British journal of surgery 2003-12, Vol.90 (12), p.1604-1607
Main Authors: Müller, S. A., Treutner, K. H., Anurov, M., Titkova, S., Oettinger, A. P., Schumpelick, V.
Format: Article
Language:English
Subjects:
Animals
Cecal Diseases - etiology
Cecal Diseases - pathology
Cecal Diseases - prevention & control
Drug Evaluation
Female
Glucans - therapeutic use
Glucose - therapeutic use
Ileal Diseases - etiology
Ileal Diseases - pathology
Ileal Diseases - prevention & control
Phospholipids - therapeutic use
Rabbits
Random Allocation
Recurrence
Tissue Adhesions - etiology
Tissue Adhesions - pathology
Tissue Adhesions - prevention & control
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Summary:Background: The formation of further adhesions after adhesiolysis is a major problem. Not all agents that are supposed to reduce de novo adhesions can reduce further adhesion formation. The efficacy and safety of intraperitoneally applied phospholipids has been shown previously. This study evaluated the influence of phospholipids and icodextrin on adhesion re‐formation. Methods: In an experimental study on 60 Chinchilla rabbits adhesions were induced by standardized abrasion of defined areas of the ventral abdominal wall, the caecum and the ileum. Open adhesiolysis was performed 10 days later. The animals randomly received either 1·5 per cent phospholipids, 4 per cent icodextrin or Ringer's lactate intraperitoneally. Half of the animals in each group were killed after a further 10 days and the remainder at 20 days. Adhesion formation was assessed by computer‐aided planimetry and histopathological examination. Results: Phospholipids (10 days: P = 0·001; 20 days: P = 0·012) and icodextrin (10 days: P = 0·006; 20 days: P = 0·055) reduced adhesion re‐formation after both intervals compared with Ringer's lactate controls. Conclusion: Phospholipids and icodextrin were effective in preventing re‐formation of adhesions. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. An approach worthy of clinical trial
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.4316