Effects of intraperitoneal mitomycin C adsorbed on activated carbon on adhesion formation and mesothelial cells in vitro.
OBJECTIVE
To investigate the incidence of adhesions after intraperitoneal instillation of mitomycin C adsorbed on activated carbon (MMC-CH).


METHODS
Animal and laboratory studies.


METHODS
University hospital, Germany.


METHODS
90 Sprague-Dawley rats.


METHODS
Laparotomy, small bowel anastomosis, and intraperitoneal instillation of saline (controls, n = 27), activated carbon alone (n = 24) or MMC-CH (n = 26). Cultures of monolayers of human mesothelial cells.


METHODS
Measurements of adhesions by planimetry. Toxicity of mitomycin C alone and charcoal alone in mesothelial cell monolayers as reflected by cell proliferation and measurement of lactate dehydrogenase activity. Concentrations of plasminogen activator (tPA) and plasminogen activator inhibitor 1 (PAI-1) as measures of the fibrinolytic activity of mesothelial cells.


RESULTS
Both activated carbon and MMC-CH caused a significant increase of adhesion formation in rats. Activated carbon also reduced the fibrinolytic activity of mesothelial cells, and mitomycin C caused concentration-dependent cytotoxicity in vitro.


CONCLUSIONS
Activated carbon combined with high concentrations of mitomycin C may cause intraperitoneal infective complications by increasing the rate of adhesion formation and reducing the fibrinolytic activity of mesothelial cells. We recommend a new absorbable carrier for intraperitoneal chemotherapy.
Jansen
M
M
Department of Surgery, University Clinic RWTH, Aachen, Germany.
Fass
J
J
Langejürgen
E
E
Forsch
S
S
Tietze
L
L
Schumpelick
V
V
D000818:Animals; D002606:Charcoal / Q000009:adverse effects* / Q000627:therapeutic use; D004195:Disease Models, Animal; D004847:Epithelial Cells / Q000187:drug effects*; D005342:Fibrinolysis / Q000187:drug effects*; D006801:Humans; D066298:In Vitro Techniques; D007274:Injections, Intraperitoneal; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D016685:Mitomycin / Q000009:adverse effects* / Q000627:therapeutic use; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D051381:Rats; D017207:Rats, Sprague-Dawley; D012008:Recurrence; D013274:Stomach Neoplasms / Q000188:drug therapy*; D016019:Survival Analysis; D000267:Tissue Adhesions / Q000209:etiology*; D010959:Tissue Plasminogen Activator / Q000097:blood
D017395:Plasminogen Activator Inhibitor 1; D002606:Charcoal; D016685:Mitomycin; D007770:L-Lactate Dehydrogenase; D010959:Tissue Plasminogen Activator