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INTRAPERITONEAL ADHESIONS AFTER OPEN OR LAPAROSCOPIC ABDOMINAL PROCEDURE: AN EXPERIMENTAL STUDY IN THE RAT
Arung, Willy; Drion, Pierre; CHERAMY-BIEN, Jean-Paul et al.
2012In Acta Chirurgica Belgica, 112 (3), p. 85.FP46
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Abstract :
[en] Objectives: Adhesion formation is common after abdominal surgery. The incidence and severity of adhesion formation following open or laparoscopic surgery remain controversial. The role of CO2 pneumoperitoneum is also largely 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 1.5cm peritoneal injury with unipolar cautery under general anesthesia: open surgery (group A, n=20), laparoscopic surgery with CO2 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 at 10mmHg. 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, respectively 95% in group A, 83% in group B and 55% in group C (P<0.01; Group C vs Group A, P<0.01). According to number, thickness, tenacity, vascularization, extent, type, and grading according to 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<0.001). Interestingly, group C rats developed significantly less adhesions at the traumatized site, and their adhesions had less severe qualitative scores compared to open surgery (P<0.01). Conclusions: In this animal model, CO2 laparoscopic surgery did not decrease the formation of postoperative adhesion, compared to open surgery. The difference with the animals operated with air pneumoperitoneum emphasizes the role of CO2 in peritoneal injury leading to adhesion formation.
Disciplines :
Surgery
Author, co-author :
Arung, Willy
Drion, Pierre ;  Université de Liège - ULiège > Département des sciences biomédicales et précliniques > GIGA-R:Méth. expér.des anim. de labo et éth. en expér. anim.
CHERAMY-BIEN, Jean-Paul  ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie cardio-vasculaire
HONORE, Pierre ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
MEURISSE, Michel ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
DEFRAIGNE, Jean ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie cardio-vasculaire
DETRY, Olivier  ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Language :
English
Title :
INTRAPERITONEAL ADHESIONS AFTER OPEN OR LAPAROSCOPIC ABDOMINAL PROCEDURE: AN EXPERIMENTAL STUDY IN THE RAT
Publication date :
May 2012
Event name :
Thirteenth Belgian Surgical Week
Event organizer :
Royal Belgian Society for Surgery
Event place :
Spa, Belgium
Event date :
du 9 au 12 mai 2012
Journal title :
Acta Chirurgica Belgica
ISSN :
1784-3421
eISSN :
2577-0160
Publisher :
Acta Medica Belgica, Bruxelles, Belgium
Volume :
112
Issue :
3
Pages :
85.FP46.
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 25 June 2012

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