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Hyperoxia and prevention of adhesion formation: a laparoscopic mouse model for open surgery
Article first published online: 13 OCT 2009
DOI: 10.1111/j.1471-0528.2009.02370.x
© 2009 The Authors Journal compilation © RCOG 2009 BJOG An International Journal of Obstetrics and Gynaecology
Issue
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 117, Issue 3, pages 331–339, February 2010
Additional Information
How to Cite
Binda, M. and Koninckx, P. (2010), Hyperoxia and prevention of adhesion formation: a laparoscopic mouse model for open surgery. BJOG: An International Journal of Obstetrics & Gynaecology, 117: 331–339. doi: 10.1111/j.1471-0528.2009.02370.x
Publication History
- Issue published online: 12 JAN 2010
- Article first published online: 13 OCT 2009
- Accepted 26 July 2009. Published Online 13 October 2009.
- Abstract
- Article
- References
- Cited By
Keywords:
- Adhesion formation;
- hyperoxia;
- laparoscopy;
- mouse model;
- open surgery;
- prevention
Please cite this paper as: Binda M, Koninckx P. Hyperoxia and prevention of adhesion formation: a laparoscopic mouse model for open surgery. BJOG 2010;117:331–339.
Objective CO2 pneumoperitoneum with more than 10% oxygen enhances adhesions. As during open surgery the peritoneum is exposed to air (20% oxygen), in this hyperoxia-enhanced adhesion model we evaluated the effect of hypothermia and products with known effectiveness in hypoxia (pure CO2 pneumoperitoneum) and normoxia (CO2 pneumoperitoneum plus 3–4% oxygen) models. Results were expected to be important for adhesion prevention in open surgery, and, moreover, similarities and differences between the three models would be important to identify differences in pathways of adhesion formation between laparoscopy and laparotomy.
Design Two experiments were performed in which the effect of hypothermia (32°C), a surfactant (phospholipids), a barrier (Hyalobarrier® gel), reactive oxygen species scavengers (superoxide dismutase, SOD, and ascorbic acid, AA), anti-inflammatory agents (dexamethasone and nimesulide), a calcium channel blocker (diltiazem) and recombinant plasminogen activator (r-PA) were evaluated upon adhesions.
Setting University Hospital.
Population BALB/c mice.
Methods Hyperoxia-enhanced adhesions were induced by performing laparoscopically bipolar lesions during 60 minutes of CO2 pneumoperitoneum plus 12% oxygen at 37°C body temperature.
Main outcome measures Adhesions were scored after 7 days.
Results In this model, adhesions were reduced by hypothermia (P < 0.02; Wilcoxon), phospholipids (P = 0.03), Hyalobarrier® gel (P < 0.004), dexamethasone (P < 0.005) and diltiazem (P < 0.01). A significant but quantitatively borderline effect was seen for AA (P < 0.002) and r-PA (P = 0.0005), whereas SOD and nimesulide did not have any effect.
Conclusions Hyperoxia-enhanced adhesions were prevented by hypothermia, dexamethasone, phospholipids, Hyalobarrier® gel, diltiazem, r-PA and AA. All effects were similar to those in the hypoxia-enhanced adhesion model, suggesting that the underlying mechanisms are similar.