Volume 7 Issue 5
Sep.  2016
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Chang REN, Da-chun ZHAO, Lan ZHU. Prevention of Postoperative Adhesions with N, O-carboxymethyl Chitosan in Rabbit: A Large-sample Gross and Histopathological Observation[J]. Medical Journal of Peking Union Medical College Hospital, 2016, 7(5): 347-352. doi: 10.3969/j.issn.1674-9081.2016.05.005
Citation: Chang REN, Da-chun ZHAO, Lan ZHU. Prevention of Postoperative Adhesions with N, O-carboxymethyl Chitosan in Rabbit: A Large-sample Gross and Histopathological Observation[J]. Medical Journal of Peking Union Medical College Hospital, 2016, 7(5): 347-352. doi: 10.3969/j.issn.1674-9081.2016.05.005

Prevention of Postoperative Adhesions with N, O-carboxymethyl Chitosan in Rabbit: A Large-sample Gross and Histopathological Observation

doi: 10.3969/j.issn.1674-9081.2016.05.005
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  • Corresponding author: ZHU Lan Tel: 010-69155649, E-mail:zhu_julie@vip.sina.com
  • Received Date: 2016-07-05
  • Publish Date: 2016-09-30
  •   Objective  To assess the effect of N, O-carboxymethyl chitosan (NOCC) in preventing postoperative adhesion in a rabbit model.  Methods  Double uterine horn model was established in 220 female rabbits to induce postoperative adhesion. The rabbits were randomized to receive either adhesion-inducing operation only (control group) or adhesion-inducing operation + intraperitoneal injection of NOCC before closure (NOCC group). All the operations were performed by one operator. Twenty-two rabbits from each group were euthanized at one of the five different time points (postoperative day 3, 7, 14, 28, and 42), and adhesion formation was scored both grossly (extent, type, and tenacity) and histopathologically (inflammation, fibrosis, and vascularization).  Results  The extent (P=0.0337) and tenacity of adhesion (P=0.0271) as well as inflammation(P < 0.0001) were lower in the NOCC group than in the control group on day 3. Fibrosis was less obvious in the NOCC group compared to the control group (P < 0.0005) before day 14. The tenacity scores of adhesion on day 14, 28, and 42 were significantly lower in the NOCC group than in the control group(all P < 0.05), while the type scores were obviously lower in the NOCC group on day 28 and 42(all P < 0.05).  Conclusions  Treatment with NOCC could reduce both gross and histopathological scores of surgery-induced abdominopelvic adhesions in rabbits. NOCC could be an effective therapy for preventing postoperative abdominopelvic adhesion.
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  • [1] Stanciu D, Menzies D. The magnitude of adhesion-related problems[J]. Colorectal Dis, 2007, 9:35-38. doi:  10.1111/j.1463-1318.2007.01346.x
    [2] Liakakos T, Thomakos N, Fine PM, et al. Peritoneal adhesions:etiology, pathophysiology, and clinical significance. Recent advances in prevention and management[J]. Dig Surg, 2001, 18:260-273. doi:  10.1159/000050149
    [3] Wiseman DM. Disorders of adhesions or adhesion-related disorder:monolithic entities or part of something bigger-CAPPS?[J]. Semin Reprod Med, 2008, 26:356-368. doi:  10.1055/s-0028-1082394
    [4] Ten Broek RP, Kok-Krant N, Bakkum EA, et al. Different surgical techniques to reduce post-operative adhesion formation:a systematic review and meta-analysis[J]. Hum Reprod Update, 2013, 19:12-25. doi:  10.1093/humupd/dms032
    [5] Sahbaz A, Aynioglu O, Isik H, et al. Bromelain:a natural proteolytic for intra-abdominal adhesion prevention[J]. Int J Surg, 2015, 14:7-11. doi:  10.1016/j.ijsu.2014.12.024
    [6] Moraloglu O, Işik H, Kilic S, et al. Effect of bevacizumab on postoperative adhesion formation in a rat uterine horn adhesion model and the correlation with vascular endothelial growth factor and Ki-67 immunopositivity[J]. Fertil Steril, 2011, 95:2638-2641. doi:  10.1016/j.fertnstert.2011.02.005
    [7] Sakai S, Ueda K, Taya M. Peritoneal adhesion prevention by a biodegradable hyaluronic acid-based hydrogel formed in situ through a cascade enzyme reaction initiated by contact with body fluid on tissue surfaces[J]. Acta Biomater, 2015, 24:152-158. doi:  10.1016/j.actbio.2015.06.023
    [8] Hellebrekers BW, Trimbos-Kemper GC, van Blitterswijk CA, et al. Effects of five different barrier materials on postsurgical adhesion formation in the rat[J]. Hum Reprod, 2000, 15:1358-1363. doi:  10.1093/humrep/15.6.1358
    [9] Ong SY, Wu J, Moochhala SM, et al. Development of a chitosan based wound dressing with improved hemostatic and antimicrobial properties[J]. Biomaterials, 2008, 29:4323-4332. doi:  10.1016/j.biomaterials.2008.07.034
    [10] Rabea EI, Badawy ME, Stevens CV, et al. Chitosan as antimicrobial agent:Applications and mode of action[J]. Biomacromolecules, 2003, 4:1457-1465. doi:  10.1021/bm034130m
    [11] Krause TJ, Goldsmith NK, Ebner S, et al. An inhibitor of cell proliferation associated with adhesion formation is suppressed by N, O-carboxymethyl chitosan[J]. J Invest Surg, 1998, 11:105-113. doi:  10.3109/08941939809032189
    [12] Zhou J, Liwski RS, Elson C, et al. Reduction in postsurgical adhesion formation after cardiac surgery in a rabbit model using N, O-carboxymethyl chitosan to block cell adherence[J]. J Thorac Cardiovasc Surg, 2008, 135:777-783. doi:  10.1016/j.jtcvs.2007.09.033
    [13] Ren C, Zhu L, Sun JC. Creation of an animal model for post-operative adhesion prevention[J]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao, 2012, 34:109-115. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgyxkxyxb201202003
    [14] Adhesion Scoring Group. Improvement of interobserver reproducibility of adhesion scoring systems[J]. Fertil Steril, 1994, 62:984-988. doi:  10.1016/S0015-0282(16)57062-9
    [15] American Fertility Society. The American Fertility Society classification of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, Mullerian anomalies and intrauterine adhesions[J]. Fertil Steril, 1988, 49:944-955. doi:  10.1016/S0015-0282(16)59942-7
    [16] Ersoy E, Ozturk V, Yazgan A, et al. Comparison of the two types of bioresorbable barriers to prevent intra-abdominal adhesions in rats[J]. J Gastrointest Surg, 2009, 13:282-286. doi:  10.1007/s11605-008-0678-5
    [17] Hooker GD, Taylor BM, Driman DK. Prevention of adhesion formation with use of sodium hyaluronate-based bioresorbable membrane in a rat model of ventral hernia repair with polypropylene mesh-A randomised, controlled study[J]. Surgery, 1999, 125:211-216. doi:  10.1016/S0039-6060(99)70267-9
    [18] Ahmad G, Mackie FL, Iles DA, et al. Fluid and pharmacological agents for adhesion prevention after gynaecological surgery[J]. Cochrane Database Syst Rev, 2014, 7:CD001298.
    [19] Costain DJ, Kennedy R, Ciona C, et al. Prevention of post-surgical adhesions with N, O-carboxymethyl chitosan:examination of the most efficacious preparation and the effect of N, O-carboxymethyl chitosan on postsurgical healing[J]. Surgery, 1997, 121:314-319. doi:  10.1016/S0039-6060(97)90360-3
    [20] Zhou J, Elson C, Lee TDG. Reduction in postoperative adhesion formation and re-formation after an abdominal operation with the use of N, O-carboxymethyl chitosan[J]. Surgery, 2004, 135:307-312. doi:  10.1016/j.surg.2003.07.005
    [21] Wang D, Mo J, Pan S, et al. Prevention of postoperative peri-toneal adhesions by O-carboxymethyl chitosan in a rat cecal abrasion mode[J]. Clin Invest Med, 2010, 33:E254-E260. doi:  10.25011/cim.v33i4.14228
    [22] Ricketts SA, Sibbons PD, Green CJ. Quantitative analysis of the development of experimentally induced post surgical adhesions:a microstereological study[J]. Int J Exp Pathol, 1999, 80:325-334.
    [23] Harris ES, Morgan RF, Rodeheaver GT. Analysis of the kinetics of peritoneal adhesion formation in the rat and evaluation of potential antiadhesive agents[J]. Surgery, 1995, 117:663-669. doi:  10.1016/S0039-6060(95)80010-7
    [24] Yeo Y, Highley CB, Bellas E, et al. In situ cross-linkable hyaluronic acid hydrogels prevent post-operative abdominal adhesions in a rabbit model[J]. Biomaterials, 2006, 27:4698-4705. doi:  10.1016/j.biomaterials.2006.04.043
    [25] Li XD, Xia DL, Shen LL, et al. Effect of "phase change" complex on postoperative adhesion prevention[J]. J Surg Res, 2016, 202:216-224. doi:  10.1016/j.jss.2015.12.033
    [26] Haney AF, Doty E. The formation of coalescing peritoneal adhesions requires injury to both contacting peritoneal surfaces[J]. Fertil Steril, 1994, 61:767-775. doi:  10.1016/S0015-0282(16)56660-6
    [27] van Hinsbergh VW, Kooistra T, Scheffer MA, et al. Characterization and fibrinolytic properties of human omental tissue mesothelial cells. Comparison with endothelial cells[J]. Blood, 1990, 75:1490-1497. doi:  10.1182/blood.V75.7.1490.1490
    [28] Hickey MJ. Role of inducible nitric oxide synthase in the re-gulation of leukocyte recruitment[J]. Clin Sci, 2001, 100:1-12.
    [29] Milligan DW, Raftery AT. Observations on the pathogenesis of peritoneal adhesions:a light and electron microscopical study[J]. Br J Surg, 1974, 61:274-280. doi:  10.1002/bjs.1800610406
    [30] Duran B, Ak D, Cetin A, et al. Reduction of postoperative adhesions by N, O-carboxymethyl chitosan and spermine NONOate in rats[J]. Exp Anim, 2003, 52:267-272. doi:  10.1538/expanim.52.267
    [31] Cetin M, Ak D, Duran B, et al. Use of methylene blue and N, O-carboxymethyl chitosan to prevent postoperative adhesions in a rat uterine horn model[J]. Fertil Steril, 2003, 80 Suppl 2:698-701.
    [32] Diamond MP, Luciano A, Johns DA, et al. Reduction of postoperative adhesions by N, O-carboxymethyl chitosan:a pilot study[J]. Fertil Steril, 2003, 80:631-636. doi:  10.1016/S0015-0282(03)00759-3
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