Efficacy of three adhesion-preventing agents in reducing severe peritoneal trauma induced by bipolar coagulation in a laparoscopic rat model.
OBJECTIVE
To compare the antiadhesion efficacy of three agents (4% icodextrin, ferric hyaluronate gel, and Ringer's lactate) in severe peritoneal trauma caused by bipolar coagulation in a laparoscopic rat model.


METHODS
Prospective, randomized, blinded experimental study.


METHODS
International Laparoscopic Surgery Centre, Clermont-Ferrand, France.


METHODS
Female Sprague-Dawley rats.


METHODS
Animals were prospectively randomized to receive one of the three agents or to be controls. Coagulation of the parietal peritoneum was performed using a bipolar 40-W current followed by administration of an antiadhesion agent. Postoperative adhesion assessment was carried out on day 7 in 42 rats.


METHODS
Adhesions were scored according to their extent and severity.


RESULTS
Adhesions occurred in all rats, however, adhesion and vascular adhesion rate scores were significantly higher in controls compared with treated groups. Adhesions were more likely to be filmy and easily separable in the 4% icodextrin group compared with the Ringer's lactate solution group.


CONCLUSIONS
Adhesion scores were decreased by the use of antiadherent agents. However, no rats were found to be free of adhesions after severe peritoneal trauma induced by 40-W bipolar coagulation of the peritoneum.
Roman
Horace
H
Department of Obstetrics, Gynecology and Reproductive Medicine, University Hospital Clermont-Ferrand, Polyclinique, Boulevard Leon Malfreyt, 63033 Clermont-Ferrand, France. horace.roman@libertysurf.fr
Canis
Michel
M
Kamble
Meenal
M
Botchorishvili
Revaz
R
Pouly
Jean-Luc
JL
Mage
Gérard
G
D000818:Animals; D004195:Disease Models, Animal; D004564:Electrocoagulation / Q000009:adverse effects*; D005260:Female; D005290:Ferric Compounds / Q000494:pharmacology; D005782:Gels; D005936:Glucans / Q000494:pharmacology*; D005947:Glucose / Q000494:pharmacology*; D006820:Hyaluronic Acid / Q000494:pharmacology; D000077607:Icodextrin; D007552:Isotonic Solutions / Q000494:pharmacology; D010535:Laparoscopy / Q000009:adverse effects*; D010537:Peritoneum / Q000601:surgery*; D011183:Postoperative Complications / Q000188:drug therapy / Q000517:prevention & control; D051381:Rats; D017207:Rats, Sprague-Dawley; D000077325:Ringer's Lactate; D012720:Severity of Illness Index; D000267:Tissue Adhesions / Q000188:drug therapy / Q000517:prevention & control*
D005290:Ferric Compounds; D005782:Gels; D005936:Glucans; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D000077607:Icodextrin; D006820:Hyaluronic Acid; D005947:Glucose