Evaluation of adhesion barrier types in a rat hepatectomy-induced adhesion model
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RESEARCH ARTICLE
Open Access
Evaluation of adhesion barrier types in a rat hepatectomy-induced adhesion model Atsushi Shimizu1, Miho Kai2*, Masako Tasaki2, Naotaka Chino2, Kiyoshi Hasegawa1 and Norihiro Kokudo3
Abstract Background: Adhesion formation after hepatectomy creates problems for repeat hepatectomy. This study aimed to compare the effectiveness of a spray (AdSpray) and sheet adhesion barrier (Seprafilm) in a rat hepatectomy-induced adhesion model. Methods: Thirty male Sprague-Dawley rats underwent partial resection of the left lateral liver lobe. They were randomly assigned to control (n = 10), AdSpray (n = 10), and Seprafilm groups. Seven days after surgery, the animals were sacrificed, and adhesions at the hepatic resection surface were blindly evaluated. Results: In the control group, adhesions were formed in all 10 animals (100%), with a 69% adhesion extent (mean). In the AdSpray group, the incidence of adhesions (40%) and the adhesion extent (mean, 10%) were significantly lower than in the control group (incidence; p = 0.0147, adhesion extent; p = 0.0007). In the Seprafilm group, the incidence of adhesions was 70%. The adhesion extent of Seprafilm (mean, 30%) was significantly lower than in the control group (p = 0.0492). No significant differences were observed between the AdSpray and Seprafilm groups. As for histopathological examination, animals in the AdSpray group showed a similar healing profile to that of the control group without delayed healing and regeneration of mesothelial cells. In contrast, the Seprafilm group showed ongoing foreign body reaction to Seprafilm, and regeneration of mesothelial cells was immature at 7 days. Conclusions: Both the spray-type gel and sheet adhesion barriers significantly reduced adhesion formation after hepatectomy. The spray-type adhesion barrier caused no adverse events and induced favorable healing. These adhesion barriers may be effective in hepatectomy. Further animal studies and clinical trials are required to determine their benefits in clinical use. Keywords: Hepatectomy, Postoperative adhesion, Adhesion barrier material, Animal adhesion model, Hydrogel
Background Repeat hepatectomy is a highly effective treatment for primary and metastatic liver cancers and has been widely performed worldwide [1–3]. However, postoperative adhesions remain an issue in repeat hepatectomy. Postoperative adhesions that form between the remnant liver and surrounding tissues can complicate repeated resection. Such adhesions carry the risk of prolonging the operation time, increasing blood loss, or organ injuries [4, 5]. * Correspondence: [email protected] 2 Terumo Corporation, R&D Center, 1500 Inokuchi, Nakai-machi, Ashigarakami-gun, Kanagawa 259-0151, Japan Full list of author information is available at the end of the article
Postoperative adhesion occurs when damage to the mesothelium at a site of organ injury due to surgical insult induces fibrin deposits, thereby creating a bridge between the injured organ and surrounding tissues. Fibrin matrix is gradually re
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