title: Assessment of the efficacy of absorbable adhesion barriers on dissection in esophagus operations.
abstract: OBJECTIVE
  During childhood, recent repeated operations for esophagus are normally conducted if long gap esophageal atresia exists. During multistaged extrathoracic esophageal elongation procedure, the dissection of the esophagus poses severe problems due to adhesion. However, Gore-Tex membrane may simplify esophagus dissection. The most popular adhesion barriers used today are sodium hyaluronate (Seprafilm; Genzyme Corp., Cambridge, MA) and oxidized regenerated cellulose (Interceed; Johnson&Johnson Medical Inc., New Brunswick, NJ). The purpose of this study is to investigate the efficacy of adhesion barriers on esophagus dissection.
  
  
  METHODS
  In the study, 21 Wistar albino adult male rats were worked on. The rats were randomly divided into three groups, each including seven rats. About 1cm-segment of the esophagus, located just behind the trachea, was dissected from the surrounding tissues through blunt dissection. Rats in group 1 were wrapped with Seprafilm, and in group 2 with Interceed. But the rats in group 3 underwent only esophagus dissection. Three weeks later, during esophagus dissection, adhesion scoring was performed and esophagus was divided into two parts: one for the assessment of hydroxyproline level, and the other for histological examination.
  
  
  RESULTS
  When the adhesion scores of the three groups were compared, there was not a significant difference between the groups (p=0.75). In terms of tissue hydroxyproline levels, mean scores of hydroxyproline revealed no significant difference between the three groups (p=0.19). When the histopathological results were examined, esophagus looked normal and no connective tissues were seen around esophagus.
  
  
  CONCLUSIONS
  Seprafilm and Interceed had no effect on esophagus dissection. Although Seprafilm had the best mean score, this was statistically insignificant. Gore-Tex might play a better role than Interceed in preventing adhesion formation; however, it is still not certain whether adhesion barrier should be used in such organs as esophagus having no serosa.
authors.affiliation: Celal Bayar University, Medical Faculty, Department of Pediatric Surgery, 45010 Manisa, Turkey. omer.yilmaz@bayar.edu.tr
authors.forename: Omer
authors.initials: O
authors.lastname: Yilmaz
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Genc
authors.forename: Fatma
authors.initials: F
authors.lastname: Taneli
authors.forename: Peyker
authors.initials: P
authors.lastname: Demireli
authors.forename: Hasan
authors.initials: H
authors.lastname: Deliaga
authors.forename: Can
authors.initials: C
authors.lastname: Taneli
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D004933:Esophageal Atresia / Q000473:pathology / Q000601:surgery*; D006820:Hyaluronic Acid; D008297:Male; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control
chemical_list: C118198:Seprafilm; D006820:Hyaluronic Acid