The experimental study on heparin, streptokinase, Vitamin-e and selenium for the prevention Of intraabdominal adhesions in rabbits

Öz

Adhesions are abdominal connections between peritoneal surfaces. Postoperative peritoneal adhesions continue to be a serious surgical problem various methods have been tried with lirriited success to reduce the ineidence of peritoneal adhesions. These methods as the prevention of fibrin depositian in the postoperative period, the removal of the fibrinous exudate, which follows any surgical procedure by peritoneal surfaces and the inhibition of fibroblast proliferation using cytotoxic agents, antihistamines and steroids. In this study, 40 unit/kg heparİn or 90.000 IU/kg streptokinase were applied intraabdominally 4 times with 12 hours intervals, vitamin-E 300 mg/kg or sodium selenit 0.5 mg/ kg IM 24 hours preoperativeiy, peroperatively and 24 hours postoperatively. All these methods found to be meaninigful better than control gruoups.

Tavşanlarda İntraabdominal Adezyonların Önlenmesinde Heparin, Streptokinaz, Vitamin-E ve Selenyum Kullanılması Üzerine Deneysel Çalışmalar

Öz

Adezyonlar, periton yüzeyleri arasında oluşan anormal birleşmelerdir. Operasyon sonrası perİtonal yapışmalar, ciddi bir cerrahi problem olarak ortaya çıkar. Sınırlı başanya sahip değişik metotlar, perİtonal adezyonlann oluşumunu azaltmak için denenmiştir.Bu metotlar, postoperatif olarak şekillenen fibrinöz eksudatın proteolitik enzimlerle lavajı, steroidler, antihistaminikler ve sitotoksik ajanlar kullanılarak fibroblastik aktivasyonun inhibisyonu ve perİtonal yüzeylerin mekanik olarak ayrılması şeklinde sınıflandınlmıştır. Bu çalışmada, heparin'in 40 ünite/kg ve streptokinaz'ın 90.000 İU/kg intraperitonal olarak ı2 saat ara ile 4 kez, vitaminE'nin 300 mg/kg ve Sodyum selenit'in 0.5 mg/kg olarak operasyondan 24 saat önce, operasyon sonrası ve 24 saat sonra olmak üzere kas içi uygulanması ile kontrol grubuna oranla başarılı sonuçlar alınmıştır.

Anahtar Kelimeler

• Tavşan
• İntraabdominal Adezyonlar
• Heparin
• Streptokinaz
• Vitamin-E
• Selenyum
• Zeki ALKAN
• Ali BUMİN
• Yaşar ŞEKER
• Tolga GÜVENÇ

Kaynakça

1. Alan, A., De Cherney, M.D. (1984). Preventing postoperative pelvic adhesions with intraperitoneal treatment. The Journal of Reproductive Medicine, 29 (3): 157-161
2. Anteplioğlu, H., Samsar, E., Akın, F. (1986). Veteriner Özel Şirurji. AÜ Basımevi, Ankara, 353-360
3. Ascheri, R., Wriedt-Lübbe, 1. , Rothe, M. (1983) . Prophylaxe intraperitonealer Adhesionen mit einem fıbrinolyticum. Medwelt, 34 (13): 410- 415
4. Bateman, B.G., Nunley, W.C., Kitchin, J.D. (1982). Prevention ofpostoperative peritoneal adhesions with ibuprofen. Fertility and Sterility, 38 (1): 107- 108
5. Batzofın, J.H., Holmes, S.D., Gibbons, W.E., Butrau, V.C.(l985). Peritoneal fluid plasminogen activator activity in endometriosis and pelvic adhesive disease. Fertility and Sterility. 44 (2): 277-279
6. Borten, M., Seibert, C.P., Taymor, M.L (1983). Recurrent anaphylactic reaction to intraperitoneal Dextran 75 used for prevention ofpostsurgical adhesions. Obstetrics and Gynecol. 61 (6): 755-756
7. Demirel, H.(l990). Postoperatif periton adezyonlannın profilaksisinde Aprotinin, Dextran 70. Antiaksidan maddeler ve fibrinolitik ajaniann kullanımı ve sonuçlan. Uzamanlık Tezi, Ankara.
8. Engle, W.A., Yoder, M.C., Baurley, J.L., Yu, pao-lo. (1988). Vitamin E decreases superoxide anion porduction buy polymorphnuclear leukocytes Pediauric Res. 23 (3): 245-248

9. Erdener, A., Çetinkurşun, S., İlhan, H., İlman, İ. (1989). Postoperatifintraperitoneal yapışıklıklann önlenmesinde Evitaminin yeri. Ulusal Cerrahi Dergisi. 5 (3): 29-3 ı
10. Fredericks, C.M., Kotry, I., Holtz, G., Askalani, AH, Serour, _G.I. (1986). Adhesion pervention in the rabbit with sodium carboxymethylcellulose solutions. Am.J.Obstet. Gynecol. 155 (3): 667-670
11. Gervin, A.S., Puckett, C.L.-Silver, D. (1972). Serosal hypofibrinolysis. A cause of postoperative adhesions. Presented at the 13.th annual meeting of the society for surgery of the alimentary tract. San Fransisco, California. !
12. Hittner, H.M., Speer, M.E., Rudolph, A.J. (1984). Retrolental fibroplasia and Vitamin E in the preterm infant-comparison of oral versus intramuscular: Oraladminstration. Prediatrics, 73 (2): 238-249.
13. James, D.C/0., Ellis, H., Hugh, T.B. (2965). The effect of streptokinase on experimental intraperitoneal adhesion formation. J.Path. Fact. 90:270- 286
14. Janic, J.S., Nagaraj, H.S., Groff, D.B (1982). Prevention ofpostoperative peritoneal adhesions. Arch. Surg. 117 (ll): 1321-1324
15. Kagoma, P.,Burger, S.N.Seifter, E. (1985). The effect of vitamin E on experimentally ınduced peritoneal adhesions in Mice. Arch. Surg. 120 (8): 949.: 951
16. Knightly, J.J., Agostino, D., Cliffi:on, E.E. (1962). The Effect of fibrinolysin and heparinon the formatian ofperitoneal adhesions. Surgery, 52 (1): 250-258
17. Krunsky, A.H., Haseltine F.P., De Chemey, A. (2984). Pentoneal fluid accumulation with Dextran 70 instilled at time of laparoscopy. Fertility and Sterility. 41 (4): 647-649
18. Lindenberg, S., Lauritsen, J.G. (1984). Prevention ofperitoneal adhesion formatian by fibrin sealant. Ann. Chinırgiae and Pharrnacologiae, 73: 11- 13
19. Milligan, D.W., Raftery, A.T. (1974): Observations on the pathogenesis of peritoneal adhesions; a light and electron microscopical study. Br. J. Surg. 61 :274-280
20. O' leary, J.A. (1985). Liquid silicone for the pereventian ofpelvic adhesions. T.J.of Reprod. Med. 30 (10): 761-763
21. Parker, J.E., Fubini, S.L., B.D.,Erb, H.N. (1987). Prevention of intraabdominal adhesions in Ponies by low-dose heparİn tehrapy. Veterinary Surgery, 16 (6): 459-462
22. Schütze, U., Buchr, H , Wurster, K., Müller, A. (1977). Zur prophylaxe peritonealer verwachsungen mit streptokinase und streptodomase varidase. Müch. Med. Wschr. 119 (4): 123-126
23. Shapiro, 1., Granat, M., Sharf, M.(l982). The effect of intraperitoneal . colchicine on the fomation of peritoneal adhesions in the rat. Arch. Gynecol. · 231:227-233
24. Skaare, J.U., Nafstad, I. (1878). Interactioon of vitamin E and seleniuro with the hepatotolic agent Dimethylnitrosamine Acta Pharrnacol. et toxicol. 43: 119-129
25. Stuyvesant, V.W., Jolley, W.B. (1967). Anti-inflamatory activity ofd-otocopherol (Vıtamiri E) and linoleik acid. Nature, 216 (11) : 585-586
26. Yavru, N., Samsar, E., Akın, F. (ı987). Büyük ve küçükbaş hayvanların bazı tarvmatik lezyonlarında DMSO (Dimethylsülfoxide) uygulamaları üzerinde klinik çalışmalar. Selçuk üniv.Vet.Fak.Derg. 3 (1): 221-232.