KALSİYUM DOBESİLAT'IN İNTRAABDOMİNAL ADEZYON ÖNLEYİCİ ETKİSİ: DENEYSEL ÇALIŞMA

THE EFFECT OF CALCIUM DOBESILATE ON THE PREVENTION OF INTRAABDOMINAL ADHESIONS: AN EXPERIMENTAL STUDY

Pınar CELEPLİ, Osman AYDIN, Yusuf Murat BAĞ, Mehmet ŞENES, Sema HÜCÜMENOĞLU, Berkay KÜÇÜK, Salih TUNCAL, Yılmaz ÜNAL, Zeynep ADIYAMAN, Bülent KILIÇOĞLU, Kemal KISMET, Ertuğrul ERTAŞ

Özet

AMAÇ: Kalsiyum Dobesilat'ın (Ca-Dob) postoperatif intraabdominal adezyon oluşumunu önlemedeki etkinliğini deneysel çekal abrazyon modelinde göstermeyi amaçladık. GEREÇ VE YÖNTEMLER: Çalışmada kullanılan 30 adet Wistar Albino dişi rat randomize olarak 3 gruba ayrıldı. Sham grubuna laparotomi yapıldı, çekum batın dışına alındıktan sonra herhangi bir işlem yapılmadan batına konuldu. Kontrol grubuna çekal abrazyon ve periton rezeksiyonu sonrası herhangi bir işlem yapılmadı. Ca-Dob grubuna çekal abrazyon ve periton rezeksiyonu yapıldıktan sonra batın kapatıldı, sadece bu gruba 21 gün boyunca 100 mg/kg/gün dozunda orogastrik yolla Ca-Dob verildi. Tüm ratlar postoperatif 21. gün sakrifiye edildi. Adezyon değerlendirmesi yapıldı. Periton ve barsaktan alınan doku örnekleri inflamasyon ve fibrozis derecelerini belirlemek için histopatolojik incelemeye gönderildi. Ayrıca, biyokimyasal analiz için doku ve kan örnekleri alındı. BULGULAR: Ca-Dob uygulanan sıçanlarda inflamasyon, makroskopik adezyon ve fibrozis skorlarının kontrol grubuna göre istatistiksel olarak anlamlı derecede düşük olduğu saptandı (p

Abstract

AIM: It was aimed to demonstrate the efficacy of Calcium Dobesilate (Ca-Dob) in preventing postoperative intra-abdominal adhesion formation in an experimental cecal abrasion model. MATERIALS AND METHODS: Thirty female Wistar Albino rats used in the study were randomized into 3 groups. Laparotomy was performed in the sham group, the cecum was removed from the abdomen and replaced without any further processing. In the control group, after cecal abrasion and peritoneal resection no processing was applied. In the Ca-Dob group, abdomen was closed after cecal abrasion and peritoneal resection, then 100 mg/kg/day Ca-Dob was administered orogastrically for 21 days only this group. All rats were sacrificed on 21st day. The adhesions were evaluated. Tissue samples taken from the peritoneum and intestines were sent for histopathological examination to determine the degree of inflammation and fibrosis. Tissue and blood samples were taken for biochemical analysis. RESULTS: Statistically, inflammation, microscopic adhesions and fibrosis scores were found to be significantly lower in the Ca-Dob administered rats compared to the control group (p < 0.05). Tissue Malondialdehyde (MDA), Fluorescent Oxidation Products (FOP) and Total Oxidation Status (TOS) values were found to be significantly lower statistically compared to the control group (p = 0.001). Tissue Total Sulfhydryl (Total SH) values were found to be statistically significantly higher (p < 0.05) in the sham group compared with the control group. Finally; serum MDA and serum TOS values in the CaDob group, was statistically significantly lower (p < 0.05) compared to control group. CONCLUSION: Ca-Dob was found to be efficacious in preventing the formation of adhesions. In addition to the demonstrated antiinflammatory effect histopathologically, the effect of antioxidant effect demonstrated biochemically was concluded to participate to the adhesion preventive efficacy of Ca-Dob. Nevertheless, there is a need for further studies to assess the precise mechanism of the preventing of abdominal adhesions of Ca-Dob.