Effect of intra-peritoneal induction of ascites fluid on the rate of postoperative intraabdominal adhesion in a rat model. (August 2022)

• Record Type: Journal Article
• Authors: Amirian, Zahra; Zardast, Mahmoud; Najmodini, Mohsen; Moghadam, Mohammadreza Ghasemian
• Is Part Of: Annals of medicine and surgery. Volume 80(2022)
• Publication Date: 2022-08
• Subjects: Intra-abdominal adhesions (IAA) -- Low SAAG -- High SAAG -- Ascites fluid; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.104129
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction: Intra-abdominal adhesions (IAAs) are secondary to peritoneal injuries such as previous surgery or intra-abdominal infections (IAIs). Accordingly, it is crucial to employ fitting techniques to minimize the likelihood of adhesions in any surgery. Due to a paucity of similar data available, this study sought to explore the effects of induced high serum ascites albumin gradient (SAAG) and low serum ascites albumin gradient (SAAG) on the rate of post-operative microscopic and macroscopic adhesion in a mouse model. Material and methods: Sixty mice were compared in six groups of ten each. Control groups (1 &4) received normal saline, groups 2&5 received high SAAG ascites fluid, and groups 3&6 received low SAAG ascites fluid intraperitoneally. These groups underwent exploratory laparotomy on day zero, followed by the same procedure on the 10th (groups 1, 2, 3) and the 30th (Groups 4, 5, 6) day of surgery. Then, microscopic and macroscopic IAAs were evaluated. Data were analyzed in SPSS software and compared with a p-value less than 0.05. Results: By comparison, the least microscopic and macroscopic IAAs after 10 and 30 days were found in the low SAAG ascites group. Revealing a statistically significant difference compared to the other two groups (P = 0.01). After 10 days of surgery, macroscopic IAA in the high SAAG group was significantly lower compared to the control and Low SAAG ascites groups. Conclusion: Intraabdominal low SAAG ascites fluid can significantly decrease the probability of postoperative fibrosis and adhesion band formation. Protocol number: IR. BUMS.REC.1399.503. Highlights: Regarding macroscopic adhesions 10 days and 30 days post laparotomy, low SAAG ascites had significantly prevented IAAs. The least microscopic and macroscopic IAAs, 10 and 30 days after surgery, were found in the low SAAG ascites group. The results of reduced IAAs using low SAAG ascites can be beneficial to the primary prevention of postoperative adhesions.