title: Intraperitoneal adhesions after open or laparoscopic abdominal procedure: an experimental study in the rat.
abstract: BACKGROUND
  Adhesion formation is common after abdominal surgery. The incidence and severity of adhesion formation following open or laparoscopic surgery remain controversial. The role of CO(2) pneumoperitoneum is also widely discussed. This study aimed to compare adhesion formation following peritoneal injury by electrocoagulation performed through open or laparoscopic procedures in a rat model.
  
  
  METHODS
  Sixty male rats were randomized to undergo a 1.5-cm peritoneal injury with unipolar cautery under general anesthesia: open surgery (Group A, n=20), laparoscopic surgery with CO(2) pneumoperitoneum (Group B, n=20), and laparoscopic surgery with air pneumoperitoneum (Group C, n=20). Duration of the procedures was fixed at 90 minutes in all groups, and pneumoperitoneum pressure was kept at 10 mm Hg. Ten days later, the animals underwent a secondary laparotomy to score peritoneal adhesions using qualitative and quantitative parameters.
  
  
  RESULTS
  Forty-five rats developed at least one adhesion: 95% in Group A, 83% in Group B, and 55% in Group C (P<.01; Group C versus Group A, P<.01). According to number, thickness, tenacity, vascularization, extent, type, and grading according to the Zühkle classification, no significant difference was observed between Groups A and B. The distribution of adhesions after open surgery was significantly different than after laparoscopic surgery (P<.001). It is interesting that Group C rats developed significantly fewer adhesions at the traumatized site, and their adhesions had less severe qualitative scores compared with those after open surgery (P<.01).
  
  
  CONCLUSIONS
  In this animal model, CO(2) laparoscopic surgery did not decrease the formation of postoperative adhesion, compared with open surgery. The difference with the animals operated on with air pneumoperitoneum emphasizes the role of CO(2) in peritoneal injury leading to adhesion formation.
authors: Department of General Surgery, University of Lubumbashi Clinics, University of Lubumbashi, Lubumbashi, Katanga Province, Democratic Republic of Congo.
authors: Willy
authors: W
authors: Arung
authors: Pierre
authors: P
authors: Drion
authors: Jean-Paul
authors: JP
authors: Cheramy
authors: Pierre
authors: P
authors: Honoré
authors: Michel
authors: M
authors: Meurisse
authors: Jean-Olivier
authors: JO
authors: Defraigne
authors: Olivier
authors: O
authors: Detry
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000818:Animals; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D010532:Peritoneal Diseases / Q000209:etiology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D000267:Tissue Adhesions / Q000209:etiology