North Clin Istanb. Ahead of Print: NCI-45548 | DOI: 10.14744/nci.2021.45548

Effects of 5-flourouracil released from different prosthetic meshes on postoperative adhesion formation in rats

Sener Balas¹, Devrim Demir Dora², Timucin Erol³, Basak Akyollu⁴, Petek Korkusuz⁵, Erhan Hamaloglu^3
1Department of General Surgery, University of Health Sciences Diskapi Training and Research Hospital, Ankara, Turkey
²Department of Medical Pharmacology Akdeniz University Faculty of Medicine, Antalya, Turkey
³Department of General Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
⁴Organ Transplantation Center, Koç University Hospital, Istanbul,Turkey
⁵Department of Histology and Embryology, Hacettepe University Faculty of Medicine, Ankara, Turkey

Objective:
Postoperative adhesion is a common problem in abdominal surgery. Especially foreign materials are strong stimulus for the development of adhesions. Aim of this study was to investigate whether drug release material coated prosthetic mesh decreases intra abdominal adhesion formation or not.
Methods:
5-FU relasing ‘chitosan gels’ were loaded to polypropylene, polyglactin- 910 grafts. Polypropylene, polyglactin- 910 grafts, chitosan gel and 5-FU loaded polyglactin 910, polypropylene grafts were used to cover abdominal defects of rats which were created under sterile conditions (n=84).Each group was divided into two subgroups (n=6). Subgroups were sacrified on 7th and 30 th days.
Results:
Seventh day macroscopic examinations were similiar. Polypropylene group was most adhesive group on 30 th day. There were less adhesions in chitosan gel and 5-FU loaded groups. Capsule and capsule margins showed no difference on both 7th and 30 th days. Polypropylene- 5-FU group, polypropylene-chitosan gel group showed signifcantly less macroscopic adhesions than polypropylene control group.Also polyglactin- 910 – chitosan gel group was less adhesive than polypropylene control group.
Conclusion:
This study showed that 5-FU decreases the adhesions but the dosage and release kinetics need further investigations.

Keywords: 5-flourouracil, polypropylene, polyglactin 910 chitosan gel,adhesions

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Ýntraabdominal Yerleþtirilen Sentetik Greft Materyallerinden Salýnan 5- Flourourasil’in Ýntraabdominal Adezyon Geliþimi Üzerine Etkisi

Sener Balas¹, Devrim Demir Dora², Timucin Erol³, Basak Akyollu⁴, Petek Korkusuz⁵, Erhan Hamaloglu^3
1Saðlýk Bilimleri Üniversitesi Dýþkapý Eðitim ve Araþtýrma Hastanesi, Genel Cerrahi Anabilim Dalý, Ankara
²Akdeniz Üniversitesi Týp Fakültesi, Týbbi Farmakoloji Anabilim Dalý, Antalya
³Hacettepe Üniversitesi Týp Fakültesi Genel Cerrahi Anabilim Dalý, Ankara
⁴Organ Nakil Merkezi, Koç Üniversitesi Hastanesi, Ýstanbul
⁵Hacettepe Üniversitesi Týp Fakültesi, Histoloji ve Embriyoloji Anabilim Dalý, Ankara

Giriþ-Amaç:
Postoperatif adezyon geliþimi abdominal cerrahide sýk karþýlaþýlan bir problemdir. Özellikle yabancý cisimler intraabdominal yapýþýklýk oluþumunda önemli etkenlerdendir. Bu çalýþmada intraabdominal yerleþtirilen greftlerden salýnan 5- Fu’nun adezyon engelleyici etkisi denetlendi.
Yöntem:
Polipropilen ve polyglactin 910 greft materyaleri üzerine 5-Fu salabilen ‘chitosan jel’ yüklendi. Steril koþullar altýnda ratlar da oluþturulan karýn duvarý defektlerine kontrol gruplarýnda polipropilen greft, poly glactin 910 greft, taþýyýcý jel, deney gruplarýna, taþýyýcý jel yüklenmiþ Polipropilen ve poliglactin 910 ve 5-Fu yüklenmiþ. Polipropilen ve poliglactin 910 yerleþtirildi.(n=84) Gruplar ikiye ayrýlýp 7. ve 30.günlerde sakrifiye edilerek örnekler incelendi(n=6).
Bulgular:
Makroskopik deðerlendirmede 7.gün yapýþýklýklarý benzer olarak bulundu.Otuzuncu günde en çok yapýþýklýk polipropilen grubunda izlendi. Taþýyýcý jel ve ilaç yüklü gruplarda daha az yapýþýklýk izlendi. Mikroskopik olarak yapýlan kapsül ve kapsül çevresi deðerlendirmelerinin istatiksel analizinde anlamlý fark gözlenmedi. Otuzuncu günde polipropilen -5 fu grubu ile polipropilen kontrol grubu arasýnda, polipropilen jel ve polipropilen kontrol gruplarý arasýnda makroskopik adezyon skoru açýsýndan anlamlý fark izlendi. (p< 0.05).Yine 30.günde polyglactin 910 - jel grubu ile polipropilen kontrol grubu arasýnda adezyon açýsýndan anlamlý fark izlendi. (p< 0.05)

Sonuç:
Bu çalýþmada intra abdominal yerleþtirilen greftlerin adezyon oluþturucu etkilerini antimetabolitlerle engellenebileceði ancak uygun doz ve salýným zamanlarý için ek araþtýrmalara ihtiyaç olduðu sonucuna varýldý. (NCI-2021-10-18)

Anahtar Kelimeler: 5-flourourasil,polipropilen, polyglaktin 910, chitosan Jel, adezyon

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