BibTex RIS Cite

Ameliyat sonrası abdominal yapışıklıkların önlenmesinde %4 icodextrin ile auto- crosslinked hyaluronic asit jel'in etkinlik ve maliyet yönünden karşılaştırılması

Year 2013, Volume: 19 Issue: 1, 25 - 29, 01.02.2013

Abstract

This experimental study was designed to compare the effects and costs of 4% icodextrin and hyaluronic acid in intraabdominal adhesion formation in rats. This study included 30 healthy Wistar albino rats, each weighing 250-300 gr. Following cecal-ileal abrasion to rats in each group, the following treatments were applied: Group 1 (control, n:10) 5 ml saline irrigation; Group 2 (n:10) 5 ml 4% icodextrin solution; Group 3 (n:10) 3 ml auto-crosslinked hyaluronic acid gel. After 14 days, following a second operation, adhesion intensity scoring, histopathological assessment (inflammation, fibrosis) and costs were compared between groups. The lowest postoperative adhesion intensity score was found in the group 3 and the highest score was found in the group 1 (p=0.028). Group 3 had a non-significantly lower adhesion intensity score than group 2 (p>0.05). In terms of inflammation and fibrosis, group 2 had the lowest score, but there were no significant differences between all the groups (p>0.05). In terms of cost, 4% icodextrin is less expensive than hyaluronic acid. The results demonstrated that both hyaluronic acid and 4% icodextrin are similarly effective in reducing postoperative intraabdominal adhesions. In addition, 4% icodextrin is more cost-effective, which can be an advantage for clinical studies.

References

  • 1. Li TC, Cooke ID. The value of an absorbable adhesions barier, interceed in the prevention of adhesions reformation following microsurgical adhesiolysis. Br J Obstet Gynaecol 1994;101:335- 9.
  • 2. Liakakos T, Thomakos N, Fine PM, Dervenis C, Young RL. Peritoneal adhesions: etiology, pathophysiology, and clinical significance. Dig Surg 2001;18:260-73.
  • 3. Hye SA, Hyuk JL, Moon WY, Sang HJ, Tae SH, Woo HK and et al. Efficacy of an injectable thermosensitive gel on postoperative adhesion in rat model. J Korean Surg Soc 2010; 79: 239-245.
  • 4. Mais V, Bracco GL, Litta P, Gargiulo T, Melis GB. Reduction of postoperative adhesions with an auto-crosslinked hyaluronan gel in gynaecological laparoscopic surgery: a blinded, controlled, randomized, multicentre study. Hum Reprod. 2006;21:1248-54.
  • 5. Becker JM, Dayton MT, Fazio VW, Beck DE, Stryker SJ, Wexner SD, et al. Prevention of postoperative abdominal adhesions by a sodium hyalurinate-based bioresorbable membrane: a prospective, randomized, double-blind multicenter study. J Am Coll Surg 1996;183:297-306.
  • 6. Salum MR, Lam DT, Wexner SD, Pikarsky A, Baig MK, Weiss EG, et al. Does limited placement of bioresorbable membrane of modified sodium hyaluronate and carboxymetylcellulose (Seprafilm®) have possible short-term beneficial impact? Dis Colon Rectum. 2001;44:706-12.
  • 7. Guida M, Acunzo G, Di Spiezio Sardo A, Bifulco G, Piccoli R, Pellicano M, et al. Effectiveness of auto-crosslinked hyaluronic acid gel in the prevention of intrauterine adhesions after hysteroscopic surgery: a prospective, randomized, controlled study. Hum Reprod 2004;19:1461-1464.
  • 8. Shamiyehı A, Danis J, Benkö L, Vattay P, Röth E, Tulipan L, et al. Effect of hyaluron derivate gel in prevention of postsurgical peritoneal adhesions-an experimental study in pigs. Hepatogastroenterology 2007;54:1121-4.

Comparison of 4% icodextrin and auto-crosslinked hyaluronic acid gel in terms of efficacy and cost effectivity in preventing postoperative abdominal adhesions

Year 2013, Volume: 19 Issue: 1, 25 - 29, 01.02.2013

Abstract

Bu deneysel çalışmada intraabdominal yapışıklıkta %4 icodextrin ve hyaluronik asitin etkinliği ve maliyetinin karşılaştırılması planlandı. Bu çalışmaya her biri 250-300 gr. 30 sağlıklı Wistar albino ratlar alındı. Her grupta ratlara çekal-ileal abrazyonu takiben: Grup1 (kontrol n:10) 5 ml saline irrigasyon; Grup 2 (n:10) 5 ml %4 icodextrin solüsyonu; grup 3 (n:10) 3ml auto-crosslinked hyaluronik asit jel uygulandı. 14 gün sonra ikinci bir ameliyatı takiben gruplar arasında yapışıklık skorlaması, histopatolojik değerlendirme (inflamasyon, fibrozis) ve maliyetler karşılaştırıldı. En düşük ameliyat sonrası yapışıklık skorlaması Grup 3'te, en yüksek grup 1'de bulundu (p:0.028). Grup 3, grup 2'den belirgin olmayacak şekilde daha düşük yapışıklık skorlamasına sahipti (p>0,05). İnflamasyon ve fibrozis açısından grup 2 en düşük skora sahipti. Ancak tüm gruplar arasında anlamlı farklılık yoktu (p>0,05). Maliyet yönünden %4 icodextrin hyaluronik asitten daha ucuzdu. Bulgular hem hyaluronik asit hem de icodextrinin ameliyat sonrası intraabdominal yapışıklıkları azaltmada benzer etkinlikte olduğunu gösterdi. Ek olarak %4 icodextrinin klinik çalışmalar için avantajlı olabilecek şekilde maliyeti daha düşüktü.

References

  • 1. Li TC, Cooke ID. The value of an absorbable adhesions barier, interceed in the prevention of adhesions reformation following microsurgical adhesiolysis. Br J Obstet Gynaecol 1994;101:335- 9.
  • 2. Liakakos T, Thomakos N, Fine PM, Dervenis C, Young RL. Peritoneal adhesions: etiology, pathophysiology, and clinical significance. Dig Surg 2001;18:260-73.
  • 3. Hye SA, Hyuk JL, Moon WY, Sang HJ, Tae SH, Woo HK and et al. Efficacy of an injectable thermosensitive gel on postoperative adhesion in rat model. J Korean Surg Soc 2010; 79: 239-245.
  • 4. Mais V, Bracco GL, Litta P, Gargiulo T, Melis GB. Reduction of postoperative adhesions with an auto-crosslinked hyaluronan gel in gynaecological laparoscopic surgery: a blinded, controlled, randomized, multicentre study. Hum Reprod. 2006;21:1248-54.
  • 5. Becker JM, Dayton MT, Fazio VW, Beck DE, Stryker SJ, Wexner SD, et al. Prevention of postoperative abdominal adhesions by a sodium hyalurinate-based bioresorbable membrane: a prospective, randomized, double-blind multicenter study. J Am Coll Surg 1996;183:297-306.
  • 6. Salum MR, Lam DT, Wexner SD, Pikarsky A, Baig MK, Weiss EG, et al. Does limited placement of bioresorbable membrane of modified sodium hyaluronate and carboxymetylcellulose (Seprafilm®) have possible short-term beneficial impact? Dis Colon Rectum. 2001;44:706-12.
  • 7. Guida M, Acunzo G, Di Spiezio Sardo A, Bifulco G, Piccoli R, Pellicano M, et al. Effectiveness of auto-crosslinked hyaluronic acid gel in the prevention of intrauterine adhesions after hysteroscopic surgery: a prospective, randomized, controlled study. Hum Reprod 2004;19:1461-1464.
  • 8. Shamiyehı A, Danis J, Benkö L, Vattay P, Röth E, Tulipan L, et al. Effect of hyaluron derivate gel in prevention of postsurgical peritoneal adhesions-an experimental study in pigs. Hepatogastroenterology 2007;54:1121-4.
There are 8 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

İlyas Başkonuş This is me

Göktürk Maralcan This is me

Avni Gökalp This is me

Ersin Borazan This is me

Hüseyin Ağtaş This is me

Publication Date February 1, 2013
Published in Issue Year 2013 Volume: 19 Issue: 1

Cite

APA Başkonuş, İ., Maralcan, G., Gökalp, A., Borazan, E., et al. (2013). Comparison of 4% icodextrin and auto-crosslinked hyaluronic acid gel in terms of efficacy and cost effectivity in preventing postoperative abdominal adhesions. Gaziantep Medical Journal, 19(1), 25-29.
AMA Başkonuş İ, Maralcan G, Gökalp A, Borazan E, Ağtaş H. Comparison of 4% icodextrin and auto-crosslinked hyaluronic acid gel in terms of efficacy and cost effectivity in preventing postoperative abdominal adhesions. Gaziantep Medical Journal. February 2013;19(1):25-29.
Chicago Başkonuş, İlyas, Göktürk Maralcan, Avni Gökalp, Ersin Borazan, and Hüseyin Ağtaş. “Comparison of 4% Icodextrin and Auto-Crosslinked Hyaluronic Acid Gel in Terms of Efficacy and Cost Effectivity in Preventing Postoperative Abdominal Adhesions”. Gaziantep Medical Journal 19, no. 1 (February 2013): 25-29.
EndNote Başkonuş İ, Maralcan G, Gökalp A, Borazan E, Ağtaş H (February 1, 2013) Comparison of 4% icodextrin and auto-crosslinked hyaluronic acid gel in terms of efficacy and cost effectivity in preventing postoperative abdominal adhesions. Gaziantep Medical Journal 19 1 25–29.
IEEE İ. Başkonuş, G. Maralcan, A. Gökalp, E. Borazan, and H. Ağtaş, “Comparison of 4% icodextrin and auto-crosslinked hyaluronic acid gel in terms of efficacy and cost effectivity in preventing postoperative abdominal adhesions”, Gaziantep Medical Journal, vol. 19, no. 1, pp. 25–29, 2013.
ISNAD Başkonuş, İlyas et al. “Comparison of 4% Icodextrin and Auto-Crosslinked Hyaluronic Acid Gel in Terms of Efficacy and Cost Effectivity in Preventing Postoperative Abdominal Adhesions”. Gaziantep Medical Journal 19/1 (February 2013), 25-29.
JAMA Başkonuş İ, Maralcan G, Gökalp A, Borazan E, Ağtaş H. Comparison of 4% icodextrin and auto-crosslinked hyaluronic acid gel in terms of efficacy and cost effectivity in preventing postoperative abdominal adhesions. Gaziantep Medical Journal. 2013;19:25–29.
MLA Başkonuş, İlyas et al. “Comparison of 4% Icodextrin and Auto-Crosslinked Hyaluronic Acid Gel in Terms of Efficacy and Cost Effectivity in Preventing Postoperative Abdominal Adhesions”. Gaziantep Medical Journal, vol. 19, no. 1, 2013, pp. 25-29.
Vancouver Başkonuş İ, Maralcan G, Gökalp A, Borazan E, Ağtaş H. Comparison of 4% icodextrin and auto-crosslinked hyaluronic acid gel in terms of efficacy and cost effectivity in preventing postoperative abdominal adhesions. Gaziantep Medical Journal. 2013;19(1):25-9.