Evaluation of sodium carboxymethylcellulose for prevention of adhesion in intestinal anastomosis in dogs

  • 심사 : 2005.07.28
  • 발행 : 2005.09.22

초록

Adhesions are the most common postoperative complication in intestinal surgery in dogs. This study was aimed at verify to the efficacy of sodium carboxymethylcellulose (SCMC) in the adhesion prevention during healing of intestinal anastomosis. Twenty three healthy dogs were taken with average 4.17 years and weight was 5.68 kg and divided into 4 groups. The dogs of group III and IV, a pedicle of greater omentum was wrapped around the suture line. In the animals of group II and IV, 1% SCMC was infused (5 ml/kg, IP) at just before closure of the abdominal cavity. Two weeks after surgery, animals were reoperated and the adhesions were evaluated and graded. We found various degrees of intraabdominal adhesions in animals of all the groups. The significantly (P<0.05) lower adhesion score was observed in group IV than that of other groups. Nevertheless, varying intra-peritoneal adhesions, healing of anastomotic site was normal in all groups. It could be concluded that intra-peritoneal administration of SCMC solution reduces postoperative adhesions without any adverse effects on healing, and a synergistic beneficial effect can be obtained by supplementation with omental graft for intestinal anastomosis.

키워드

참고문헌

  1. 이충헌, 신영규, 정순욱, 이채용. 개의 단단장문합술에서 단순결절접합봉합과 단층연속코넬봉합의 비교. 한국임상수의학회지 2001, 18, 124-132
  2. Adams W, Ctercteko G, Bilous M. Effect of an omental wrap on the healing and vascularity of compromised intestinal anastomoses. Dis Colon Rectum 1992, 35, 731-738 https://doi.org/10.1007/BF02050320
  3. Allen DA, Smeak DD, Schertel ER. Prevalence of small intestinal dehiscence an associated clinical factors, a retrospective study of 121 dogs. J Am Anim Hosp Assoc 1992, 28, 70-76
  4. Diamond MP, DeCherney AH. Pathogenesis of adhesions formation/reformation, Application to reproductive pelvic surgery. Microsurgery 1987, 8, 103-108 https://doi.org/10.1002/micr.1920080215
  5. Diamond MP, Linsky CB, Cunningham T, Kamp L, Pines E, Decherney AH, diZerega GS. Synergistic effects of INTERCEED (TC 7) and heparin in reducing adhesion formation in the rabbit uterine horn model. Fertil Steril 1991, 55, 389-394 https://doi.org/10.1016/S0015-0282(16)54134-X
  6. Diamond MP, Decherney AH, Lincky CB, Cunningham T, Constantine B. Assessment of sodium carboxymethylcellulose and 32% Dextran 70 for prevention of adhesoins in a rabbit uterine horn model. Int J Fertil 1988, 33, 278-282
  7. Dockendorf BL, Frazee RC, Matheny RG. Omental pedicle graft to improve ischemic anastomoses. South Med J 1993, 86, 628-632 https://doi.org/10.1097/00007611-199306000-00007
  8. Ellison GW. Intestinal resection and anastomosis. In: Bojarb MJ, Birchard SJ, Tomlinson J. Current techniques in small animal surgery. 4th ed. pp. 248-254. Lea & Rebiger., Philadelphia 1998
  9. Ellison GW. End-to-end anastomosis in the dog, a comparation of techniques, Compend Contin Edu Pract Vet 1981, 3, 486-495
  10. Ellison GW, Jokinen MP, Park RD. End-to-end approximating intestinal anastomoses in the dog, a comparative fluorescein dye, angiographic and histologic evaluation. J Am Anim Hop Asso 1982, 18, 729-736
  11. Ellison H. The cause and prevention of postoperative intraperitoneal adhesions. Surg Gynecol Obstet 1971, 133, 497-508
  12. Ellis H. The cause and prevention of intestinal adhesions. Br J Surg 1982, 69, 241-243 https://doi.org/10.1002/bjs.1800690502
  13. Ellis H. The aetiology of post-operative abdominal adhesion, an experimental study. Br J Surg 1962, 50, 6-10
  14. Elkins TE, Bury RJ, Ritter JL, Ling FW, Ahokas RA, Homsey CA, Malinak LR. Adhesion prevention by solutions of sodium carboxymethylcellulose in the rat, I. Fertil Steril 1984, 41, 926-928 https://doi.org/10.1016/S0015-0282(16)47909-4
  15. Elkins TE, Ling FW, Ahokas RA, Abdella TN, Homsey CA, Malinak LR. Adhesion prevention by solutions of sodium carboxymethylcellulose in the rat. Fertil Steril 1984, 41, 929-932 https://doi.org/10.1016/S0015-0282(16)47910-0
  16. Fredericks CM, Kotry I, Holtz G, Askalani AH, Serour GI. Adhesion prevention in the rabbit with sodium carboxymethylcellulose solutions. Am J Obstet Gynecol 1986, 155, 667-670 https://doi.org/10.1016/0002-9378(86)90304-2
  17. Greenfield CL, Walshaw R. Open peritoneal drainage for treatment of contaminated peritoneal cavity and septic peritonitis in dogs and cats, 24 cases (1980-1986). J Am Vet Med Assoc 1987, 191, 100-105
  18. Hadaegh A, Burns J, Burgess L, Rose R, Rowe E, LaMorte WW, Becker JM. Effects of hyaluronic acid/carboxymethylcellulose gel on bowel anastomoses in the New Zealand white rabbit. J Gastrointest Surg 1997, 1, 569-575 https://doi.org/10.1016/S1091-255X(97)80074-1
  19. Heidrick GW, Pippitt CH Jr, Morgan MA, Thurnau GR. Efficacy of intraperitoneal sodium carboxymethylcellulose in preventing postoperative adhesion formation. J Reprod Med 1994, 39, 575-578
  20. Holtz G. Current use of ancillary modalities for adhesion prevention. Fertil Steril 1985, 44, 174-176 https://doi.org/10.1016/S0015-0282(16)48730-3
  21. Jansen RPS. Failure of peritoneal irrigation with heparin during pelvic operations upon young women to reduce adhesions. Surg Gynecol Obstet 1988, 166, 154-160
  22. Khoury GA, Waxman BP. Large bowel anastomosis, I. The healing process and sutured anastomoses, A review. Br J Surg 1983, 70, 61-63 https://doi.org/10.1002/bjs.1800700202
  23. Mclachlin AD, Denton DW. Omental protection of intestinal anstomoses. Am J Surg 1973, 125, 134-140 https://doi.org/10.1016/0002-9610(73)90018-4
  24. Moll HD, Wolfe DF, Schmacher J, Wright JC. Evaluation of sodium carboxymethylcellulose for prevention of adhesions after uterine trauma in ewes. Am J Vet Res 1991, 53, 1454-1456
  25. Moll HD, Schumacher J, Wright JC, Spano JS. Evaluation of sodium carboxymethylcellulose for prevention of experimentally induced abdominal adhesions in ponies. Am J Vet Res 1991, 52, 88-91
  26. Morison R. Remarks on some functions of the omentum. BMJ 1906, 1, 76-78 https://doi.org/10.1136/bmj.1.2350.76
  27. Muller PO, Harmon BG, Hay WP, Amoroso LM. Effect of carboxymethylcellulose and yaluronatecarboxymethylcellulose membrane on healing of intestinal anastomoses in horses. Am J Vet Res 2000, 60, 369-374
  28. Muller PO, Hunt RJ, Allen D, Parks AH, Hay WP. Intraperitoneal use of sodium carboxymethylcellulose in horses undergoing exploratory celiotomy. Vet Surg 1995, 24, 112-117 https://doi.org/10.1111/j.1532-950X.1995.tb01304.x
  29. Mueller PO, Randall BE. Prevention and treatment of gastrointestinal adhesions. Vet Clin Equine 2003, 19, 741-763 https://doi.org/10.1016/j.cveq.2003.08.014
  30. Myllarniemo H. Foreign material in adhesion formation after abdominal surgery, a clinical and experimental study. Acta Chir Scand Suppl 1967, 377, 1-48
  31. O Brien WF, Drake TS, Bibro MC. The use of ibuprofen and dexamethasone on the prevention of postoperative adhesion formation. Obstet Gynecol 1982, 60, 373-378
  32. Pelvletic MM, Berg J. Gastrointestinal surgery. In: Lipowitz AJ, Caywood DD, Newton CD, Schwartz A. Complication in small animal surgery, 1st ed. pp. 372-379, Wiliams & Wilkins., Baltmore. 1996
  33. Replogle RL, Jhonson R, Gross RE. Prevention of postoperative intestinal adhesions with combined promethazine and dexamethasone therapy, experimental and clinical studies. Ann Surg 1966, 118, 580-588