Yıl: 2023 Cilt: 53 Sayı: 5 Sayfa Aralığı: 1112 - 1119 Metin Dili: İngilizce DOI: 10.55730/1300-0144.5676 İndeks Tarihi: 24-11-2023

The effect of natural surfactants on the development of postoperative intraabdominal adhesion

Öz:
Background/aim: The development of postoperative adhesion after abdominal surgery is sometimes a severe problem. Our study investigates the effectiveness of exogenous surfactant application in preventing adhesion development in the experimental adhesion model. Materials and methods: This randomized-controlled interventional study was carried out in the animal laboratory of Kahramanmaraş Sütçü İmam University between March 1 and March 31, 2020. An experimental intra-abdominal adhesion model was established in 24 adult female rats by cecal abrasion. Rats were randomly divided into four groups. Groups I, II, and III were taken intraperitoneally as beractant, poractant, and calfactant applied groups, respectively. Group IV was the control group. Relaparotomy was performed in all groups on the 15th postoperative day, and intra-abdominal adhesions were scored macroscopically according to the Canbaz scoring system. In addition, the cecal regions were evaluated microscopically and scored according to the Zühlke microscopic classification system. The scores of the groups were compared statistically. Results: The Zühlke adhesion development score was significantly lower in the exogenous surfactant applied groups. In addition, when the surfactant-applied groups were compared among themselves, it was seen that the adhesion score in the beractant group was significantly better than the other surfactant types (p < 0.01). Conclusion: Our study results showed that prophylactic intraperitoneal surfactant application significantly reduced postoperative adhesion development, particularly beractant.
Anahtar Kelime: Postoperative adhesion surface-active phospholipids pulmonary surfactant beractant poractant calfactant

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Arslan S, Zeytun H, Basuguy E, İbiloğlu İ, Uygun İ et al. Cordycepin prevents postoperative formation of intra- abdominal adhesion in a rat model: An experimental study. Ulusal Travma ve Acil Cerrahi Dergisi 2017; 23(4): 273-278. https://doi.org/10.5505/tjtes.2016.48979
  • 2. Yilmaz Y, Celik IH, Pampal A, Demirel G, Topal F et al. Effects of different pulmonary surfactants in the prevention of postoperative intraabdominal adhesion formation. Journal of Pediatric Surgery 2012; 47(8):1560-1565. https://doi. org/10.1016/j.jpedsurg.2012.01.080
  • 3. Arslan E, Irkorucu O, Sozutek A, Cetinkunar S, Reyhan E et al. The potential efficacy of Survanta (r) and Seprafilm (r) on preventing intra-abdominal adhesions in rats. Acta Cirurciga Brasileira 2016; 31(6): 389-395. https://doi.org/10.1590/ S0102-865020160060000005
  • 4. Brüggmann D, Tchartchian G, Wallwiener M, Münstedt K, Tinneberg HR et al. Intra-abdominal adhesions: definition, origin, importance in surgical practice and treatment options. Deutsches Ärzteblatt International 2010; 107(44):769-775. https://doi.org/10.3238/arztebl.2010.0769
  • 5. Reijnen MM, Bleichrodt RP, van Goor H. Pathophysiology of intra-abdominal adhesion and abscess formation, and the effect of hyaluronan. British Journal of Surgery 2003; 90(5):533-541. https://doi.org/10.1002/bjs.4141
  • 6. Fukuhira Y, Ito M, Kaneko H, Sumi Y, Tanaka M et al. Prevention of postoperative adhesions by a novel honeycomb- patterned poly (lactide) film in a rat experimental model. Journal of Biomedical Materials Research Part B: Applied Biomaterials 2008; 86(2):353-359. https://doi.org/10.1002/ jbm.b.31026
  • 7. Cömert M, Karakaya K, Barut F, Karadeniz Çakmak G, Uçan HB et al. Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions? Ulus Travma Ve Acil Cerrahi Dergisi 2010; 16(5):383-389. https://pubmed. ncbi.nlm.nih.gov/21038113/
  • 8. Ellis H, Moran BJ, Thompson JN, Parker MC, Wilson MS et al. Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study. Lancet. 1999; 353(9163):1476-1480. https://doi.org/10.1016/S0140- 6736(98)09337-4
  • 9. Moris D, Chakedis J, Rahnemai-Azar AA, Wilson A, Hennessy MM et al. Postoperative Abdominal Adhesions: Clinical Significance and Advances in Prevention and Management. Journal of Gastrointestinal Surgery 2017; 21(10):1713-1722. https://doi.org/10.1007/s11605-017-3488-9
  • 10. Hills BA. Role of surfactant in peritoneal dialysis. Peritoneal Dialysis International 2000; 20(5):503-515. http://dx.doi. org/10.1177/089686080002000505
  • 11. Ar’Rajab A, Ahrén B, Rozga J, Bengmark S. Phosphatidylcholine prevents postoperative peritoneal adhesions: an experimental study in the rat. Journal of Surgical Research 1991; 50(3):212- 215. https://doi.org/10.1016/0022-4804(91)90180-t
  • 12. Chen Y, Hills BA. Surgical adhesions: evidence for adsorption of surfactant to peritoneal mesothelium. Australian and New Zealand Journal of Surgery 2000; 70(6):443-447. https://doi. org/10.1046/j.1440-1622.2000.01841.x
  • 13. Chen Y, Burke JR, Hills BA. Semipermeability imparted by surface-active phospholipid in peritoneal dialysis. Peritoneal Dialysis International 2002; 22(3):380-385. https://doi. org/10.1177/089686080202200313
  • 14. Guide Laboratory Animals for the Care and Use of Laboratory Anımals Eighth Edition 2011 by the National Academy of Sciences. Available from: https://olaw.nih.gov/sites/default/files/ Guide-for-the-Care-and-Use-of-Laboratory-Animals.pdf
  • 15. Hemadeh O, Chilukuri S, Bonet V, Hussein S, Chaudry IH. Prevention of peritoneal adhesions by administration of sodium carboxymethyl cellulose and oral vitamin E. Surgery 1993; 114(5):907-910. https://doi.org/10.5555/ uri:pii:0039606093902286
  • 16. Canbaz MA, Ustün C, Koçak I, Yanik FF. The comparison of gonadotropin-releasing hormone agonist therapy and intraperitoneal Ringer’s lactate solution in prevention of postoperative adhesion formation in rat models. European Journal of Obstetrics and Gynecology and Reproductive Biology 1999; 82 (2):219-222. https://doi.org/10.1016/S0301- 2115(98)00230-9
  • 17. Zühlke HV, Lorenz EM, Straub EM, Savvas V. Pathophysiologie und Klassifikation von Adhäsionen [Pathophysiology and classification of adhesions]. Langenbecks Archiv für Chirurgie Gegründet 1860 Kongreßorgan der Deutschen Gesellschaft für Chirurgie 1990:1009-1016. https://doi.org/10.1007/978-3-642- 48163-5_212
  • 18. Fessler MB, Summer RS. Surfactant Lipids at the Host- Environment Interface. Metabolic Sensors, Suppressors, and Effectors of Inflammatory Lung Disease. American Journal of Respiratory Cell and Molecular Biology 2016; 54(5):624-635. https://doi.org/10.1165/rcmb.2016-0011PS
  • 19. Kang D, Chugunova M, Nadim A, Waring AJ, Walther FJ. Modeling coating flow and surfactant dynamics inside the alveolar compartment. Journal of Engineering Mathematics 2018; 113:23-43 https://doi.org/10.1007/s10665-018-9972-8
  • 20. Krylov PA, Astakhov AS, Nesmeyanova EN, Borozdina NA, Novochadov VV. Evaluation of the Efficiency of Lubricant Based on Pulmonary Surfactant in Experimental Knee Osteoarthritis in Rats: Analysis of 3D Reconstructions. Bulletin of Experimental Biology and Medicine 2020; 168(3):371-374. https://doi.org/10.1007/s10517-020-04711-1
  • 21. Nkadi PO, Merritt TA, Pillers DA. An overview of pulmonary surfactant in the neonate: genetics, metabolism, and the role of surfactant in health and disease. Molecular Genetics and Metabolism 2009; 97(2):95-101. https://doi.org/10.1016/j. ymgme.2009.01.015
  • 22. Nguyen ATM, Holland AJA. Paediatric adhesive bowel obstruction: a systematic review. Pediatric Surgery International 2021; 37(6):755-763. https://doi.org/10.1007/s00383-021- 04867-5
  • 23. Junga A, Pilmane M, Ābola Z, Volrāts O. The Morphopathogenetic Aspects of Intraabdominal Adhesions in Children under One Year of Age. Medicina 2019; 55(9):556. https://doi.org/10.3390/medicina55090556
  • 24. Lakshminarayanan B, Hughes-Thomas AO, Grant HW. Epidemiology of adhesions in infants and children following open surgery. Seminars in Pediatric Surgery 2014; 23(6):344- 348. https://doi.org/10.1053/j.sempedsurg.2014.06.005
  • 25. Struijs MC, Poley MJ, Meeussen CJ, Madern GC, Tibboel D et al. Late vs early ostomy closure for necrotizing enterocolitis: analysis of adhesion formation, resource consumption, and costs. Journal of Pediatric Surgery 2012; 47(4):658-664. https:// doi.org/10.1016/j.jpedsurg.2011.10.076
  • 26. Bazacliu C, Neu J. Necrotizing Enterocolitis: Long Term Complications. Current Pediatric Reviews 2019; 15(2):115-124. https://doi.org/10.2174/1573396315666190312093119
  • 27. Fredriksson F, Christofferson RH, Lilja HE. Adhesive small bowel obstruction after laparotomy during infancy. British Journal of Surgery 2016; 103(3):284-289. https://doi. org/10.1002/bjs.10072
  • 28. Tsaousi G, Stavrou G, Fotiadis K, Kotzampassi K, Kolios G. Implementation of phospholipids as pharmacological modalities for postoperative adhesions prevention. European Journal of Pharmacology 2019; 5;842:189-196. https://doi. org/10.1016/j.ejphar.2018.10.054
  • 29. Beavis J, Harwood JL, Coles GA, Williams JD. Synthesis of phospholipids by human peritoneal mesothelial cells. Peritoneal Dialysis International 1994;14(4):348-355 https:// doi.org/10.1177/089686089401400407
  • 30. Snoj M. Intra-abdominal adhesion formation is initiated by phospholipase A2. Medical Hypotheses 1993; 41(6):525-528. https://doi.org/10.1016/0306-9877(93)90109-4
  • 31. Chen Y, Hills BA, Hills YC. Unsaturated phosphatidylcholine and its application in surgical adhesion. ANZ Journal of Surgery 2005; 75(12):1111-1114. https://doi.org/10.1111/ j.1445-2197.2005.03619.x
  • 32. Mikolka P, Curstedt T, Feinstein R, Larsson A, Grendar M, et al. Impact of synthetic surfactant CHF5633 with SP-B and SP-C analogues on lung function and inflammation in rabbit model of acute respiratory distress syndrome. Physiological Reports 2021; 9(1):e14700. https://doi.org/10.14814/phy2.14700
  • 33. Kovács T, Varga G, Erces D, Tőkés T, Tiszlavicz L, et al. Dietary phosphatidylcholine supplementation attenuates inflammatory mucosal damage in a rat model of experimental colitis. Shock 2012; 38(2):177-85. https://doi.org/10.1097/ SHK.0b013e31825d1ed0
  • 34. Strauss T, Rozenzweig N, Rosenberg N, Shenkman B, Livnat T et al. Surfactant impairs coagulation in-vitro: a risk factor for pulmonary hemorrhage? Thrombosis Research 2013; 132(5):599-603. https://doi.org/10.1016/j.thromres.2013.09.001
  • 35. Elssner A, Mazur G, Vogelmeier C. Inhibition of factor XIIIa- mediated incorporation of fibronectin into fibrin by pulmonary surfactant. American Journal of Physiology-Lung Cellular and Molecular Physiology 1999; 276(4):L625-630. https://doi. org/10.1152/ajplung.1999.276.4.L625
APA güler a, Karakaya A, Doğan A, Bahar A, YURTTUTAN S (2023). The effect of natural surfactants on the development of postoperative intraabdominal adhesion. , 1112 - 1119. 10.55730/1300-0144.5676
Chicago güler ahmet gökhan,Karakaya Ali Erdal,Doğan Ahmet Burak,Bahar Abdulkadir Yasir,YURTTUTAN SADIK The effect of natural surfactants on the development of postoperative intraabdominal adhesion. (2023): 1112 - 1119. 10.55730/1300-0144.5676
MLA güler ahmet gökhan,Karakaya Ali Erdal,Doğan Ahmet Burak,Bahar Abdulkadir Yasir,YURTTUTAN SADIK The effect of natural surfactants on the development of postoperative intraabdominal adhesion. , 2023, ss.1112 - 1119. 10.55730/1300-0144.5676
AMA güler a,Karakaya A,Doğan A,Bahar A,YURTTUTAN S The effect of natural surfactants on the development of postoperative intraabdominal adhesion. . 2023; 1112 - 1119. 10.55730/1300-0144.5676
Vancouver güler a,Karakaya A,Doğan A,Bahar A,YURTTUTAN S The effect of natural surfactants on the development of postoperative intraabdominal adhesion. . 2023; 1112 - 1119. 10.55730/1300-0144.5676
IEEE güler a,Karakaya A,Doğan A,Bahar A,YURTTUTAN S "The effect of natural surfactants on the development of postoperative intraabdominal adhesion." , ss.1112 - 1119, 2023. 10.55730/1300-0144.5676
ISNAD güler, ahmet gökhan vd. "The effect of natural surfactants on the development of postoperative intraabdominal adhesion". (2023), 1112-1119. https://doi.org/10.55730/1300-0144.5676
APA güler a, Karakaya A, Doğan A, Bahar A, YURTTUTAN S (2023). The effect of natural surfactants on the development of postoperative intraabdominal adhesion. Turkish Journal of Medical Sciences, 53(5), 1112 - 1119. 10.55730/1300-0144.5676
Chicago güler ahmet gökhan,Karakaya Ali Erdal,Doğan Ahmet Burak,Bahar Abdulkadir Yasir,YURTTUTAN SADIK The effect of natural surfactants on the development of postoperative intraabdominal adhesion. Turkish Journal of Medical Sciences 53, no.5 (2023): 1112 - 1119. 10.55730/1300-0144.5676
MLA güler ahmet gökhan,Karakaya Ali Erdal,Doğan Ahmet Burak,Bahar Abdulkadir Yasir,YURTTUTAN SADIK The effect of natural surfactants on the development of postoperative intraabdominal adhesion. Turkish Journal of Medical Sciences, vol.53, no.5, 2023, ss.1112 - 1119. 10.55730/1300-0144.5676
AMA güler a,Karakaya A,Doğan A,Bahar A,YURTTUTAN S The effect of natural surfactants on the development of postoperative intraabdominal adhesion. Turkish Journal of Medical Sciences. 2023; 53(5): 1112 - 1119. 10.55730/1300-0144.5676
Vancouver güler a,Karakaya A,Doğan A,Bahar A,YURTTUTAN S The effect of natural surfactants on the development of postoperative intraabdominal adhesion. Turkish Journal of Medical Sciences. 2023; 53(5): 1112 - 1119. 10.55730/1300-0144.5676
IEEE güler a,Karakaya A,Doğan A,Bahar A,YURTTUTAN S "The effect of natural surfactants on the development of postoperative intraabdominal adhesion." Turkish Journal of Medical Sciences, 53, ss.1112 - 1119, 2023. 10.55730/1300-0144.5676
ISNAD güler, ahmet gökhan vd. "The effect of natural surfactants on the development of postoperative intraabdominal adhesion". Turkish Journal of Medical Sciences 53/5 (2023), 1112-1119. https://doi.org/10.55730/1300-0144.5676