Efficacy of barriers and hypoxia-inducible factor inhibitors to prevent CO(2) pneumoperitoneum-enhanced adhesions in a laparoscopic mouse model.
OBJECTIVE
To investigate the effects of hypoxia-inducible factor (HIF) inhibitors, flotation agents, barriers, and a surfactant on pneumoperitoneum-enhanced adhesions in a laparoscopic mouse model.


METHODS
Prospective randomized trial (Canadian Task Force classification I).


METHODS
Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Catholic University of Leuven.


METHODS
One hundred fourteen female BALB/c mice.


METHODS
Adhesions were induced during laparoscopy in BALB/c female mice. Pneumoperitoneum was maintained for 60 minutes with humidified CO(2). In 3 experiments the effects of HIF inhibitors such as 17-allylamino 17-demethoxygeldanamycin, radicicol, rapamycin, and wortmanin, flotation agents such as Hyskon and carboxymethylcellulose, barriers such as Hyalobarrier gel and SprayGel, and surfactant such as phospholipids were evaluated.


RESULTS
Adhesions were scored after 7 days during laparotomy. Adhesion formation decreased with the administration of wortmannin (p <.01), phospholipids (p <.01), Hyalobarrier Gel (p <.01), and SprayGel (p <.01).


CONCLUSIONS
These experiments confirm the efficacy of barriers and phospholipids to separate or lubricate damaged surfaces. They also confirm the role of mesothelial hypoxia in this model by the efficacy of the HIF inhibitor wortmannin.
Binda
Maria Mercedes
MM
Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium. MariaMercedes.Binda@uz.kuleuven.ac.be
Molinas
Carlos Roger
CR
Bastidas
Adriana
A
Jansen
Marc
M
Koninckx
Philippe Robert
PR
D000730:Androstadienes / Q000494:pharmacology*; D000818:Animals; D001704:Biopolymers / Q000494:pharmacology; D002245:Carbon Dioxide / Q000009:adverse effects; D004195:Disease Models, Animal; D004791:Enzyme Inhibitors / Q000494:pharmacology*; D005260:Female; D000860:Hypoxia / Q000473:pathology; D010535:Laparoscopy / Q000009:adverse effects*; D051379:Mice; D008807:Mice, Inbred BALB C; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D011897:Random Allocation; D013501:Surface-Active Agents / Q000494:pharmacology; D000267:Tissue Adhesions / Q000517:prevention & control*; D000077191:Wortmannin
D000730:Androstadienes; D001704:Biopolymers; D004791:Enzyme Inhibitors; D013501:Surface-Active Agents; D002245:Carbon Dioxide; D000077191:Wortmannin