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

Yıl 1996, Cilt: 8 Sayı: 3, 114 - 127, 01.12.1996

Zeki Alkan Ali Bumin Yaşar Şeker Tolga Güvenç

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

• Alan, A., De Cherney, M.D. (1984). Preventing postoperative pelvic adhesions with intraperitoneal treatment. The Journal of Reproductive Medicine, 29 (3): 157-161
• Anteplioğlu, H., Samsar, E., Akın, F. (1986). Veteriner Özel Şirurji. AÜ Basımevi, Ankara, 353-360
• Ascheri, R., Wriedt-Lübbe, 1. , Rothe, M. (1983) . Prophylaxe intraperitonealer Adhesionen mit einem fıbrinolyticum. Medwelt, 34 (13): 410- 415
• Bateman, B.G., Nunley, W.C., Kitchin, J.D. (1982). Prevention ofpostoperative peritoneal adhesions with ibuprofen. Fertility and Sterility, 38 (1): 107- 108
• 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
• 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
• Demirel, H.(l990). Postoperatif periton adezyonlannın profilaksisinde Aprotinin, Dextran 70. Antiaksidan maddeler ve fibrinolitik ajaniann kullanımı ve sonuçlan. Uzamanlık Tezi, Ankara.
• 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
• Erdener, A., Çetinkurşun, S., İlhan, H., İlman, İ. (1989). Postoperatifintraperitoneal yapışıklıklann önlenmesinde Evitaminin yeri. Ulusal Cerrahi Dergisi. 5 (3): 29-3 ı
• 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
• 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. !
• 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.
• 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
• Janic, J.S., Nagaraj, H.S., Groff, D.B (1982). Prevention ofpostoperative peritoneal adhesions. Arch. Surg. 117 (ll): 1321-1324
• 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
• 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
• 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
• Lindenberg, S., Lauritsen, J.G. (1984). Prevention ofperitoneal adhesion formatian by fibrin sealant. Ann. Chinırgiae and Pharrnacologiae, 73: 11- 13
• 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
• O' leary, J.A. (1985). Liquid silicone for the pereventian ofpelvic adhesions. T.J.of Reprod. Med. 30 (10): 761-763
• 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
• 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
• 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
• Skaare, J.U., Nafstad, I. (1878). Interactioon of vitamin E and seleniuro with the hepatotolic agent Dimethylnitrosamine Acta Pharrnacol. et toxicol. 43: 119-129
• Stuyvesant, V.W., Jolley, W.B. (1967). Anti-inflamatory activity ofd-otocopherol (Vıtamiri E) and linoleik acid. Nature, 216 (11) : 585-586
• 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.