title: The Impact of 0.9% NaCl on Mesothelial Cells After Intraperitoneal Lavage During Surgical Procedures.
abstract: BACKGROUND
  Normal saline gained wide popularity in abdominal surgery as a basic compound used in intraoperative drainage of the peritoneal cavity. However, recent studies have revealed that saline solution is not quite biocompatible with the intraperitoneal enviroment and may promote peritoneal adhesions.
  
  
  OBJECTIVE
  The aim of the study was to evaluate the function and viability of human mesothelial cells cultured in vitro in 0.9% NaCl solution from intraperitoneal lavage carried out during laparoscopic cholecytectomies.
  
  
  METHODS
  The study included 40 consecutive patients suffering from gallstones who underwent laparoscopic cholecystectomy. Fluid was collected after intraperitoneal lavage during the surgical procedures. The samples obtained were used as a medium for in vitro incubation of primary human mesothelial cells. After 24 h the synthesis of interleukin 6 (IL-6), plasminogen activator inhibitor (PAI) and tissue plasminogen activator (tPA), as well as the index of cell proliferation were assessed in all the experimental groups.
  
  
  RESULTS
  All the mesothelium cell cultures treated with fluid samples obtained ex vivo were characterized by elevated levels of IL-6. The highest concentrations of PAI-1 were found in groups of cells exposed to fluid with bile; similarly, tPA synthesis was extremely elevated in groups treaded with fluid containing bile and small amounts of hemolyzed blood. In contrast, cell proliferation was exceedingly high in 2 groups of cells placed in a standard culture medium and in 0.9% NaCl solution.
  
  
  CONCLUSIONS
  Normal saline introduced into the abdominal cavity modifies the biological and physicochemical conditions of the intraperitoneal environment. The impact of 0.9% NaCl on mesothelial cells is manifested in destabilized tissue regeneration, which supposedly initiates adhesion formation.
authors.affiliation: Department of Pathophysiology, Poznan University of Medical Sciences, Poland.|Heliodor Swiecicki Clinic Hospital, Poznan University of Medical Sciences, Poland.|Department of General, Gastroenterological and Endocrine Surgery, Poznan University of Medical Sciences, Poland.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Cwaliński
authors.affiliation: Department of Pathophysiology, Poznan University of Medical Sciences, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Bręborowicz
authors.affiliation: Department of Pathophysiology, Poznan University of Medical Sciences, Poland.
authors.forename: Alicja
authors.initials: A
authors.lastname: Połubińska
mesh_terms: D049109:Cell Proliferation / Q000187:drug effects; D003470:Culture Media / Q000494:pharmacology; D004847:Epithelial Cells / Q000166:cytology* / Q000187:drug effects; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D010533:Peritoneal Lavage; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D012965:Sodium Chloride / Q000494:pharmacology*; D013514:Surgical Procedures, Operative; D010959:Tissue Plasminogen Activator / Q000378:metabolism
chemical_list: D003470:Culture Media; D015850:Interleukin-6; D017395:Plasminogen Activator Inhibitor 1; D012965:Sodium Chloride; D010959:Tissue Plasminogen Activator
keywords: fibrinolytic disability; intraperitoneal lavage; oxidative stress; peritoneal adhesions; tPA/PAI-1 ratio