#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Practical considerations in the use of a porcine model (Sus scrofa domesticus) to assess prevention of postoperative peritubal adhesions


Autoři: Claudio Peixoto Crispi, Jr. aff001;  Claudio Peixoto Crispi aff001;  Fernando Luis Fernandes Mendes aff003;  Claudio Moura de Andrade, Jr aff001;  Leon Cardeman aff004;  Nilton de Nadai Filho aff001;  Elyzabeth Avvad Portari aff005;  Marlon de Freitas Fonseca aff005
Působiště autorů: Surgical Training Center, SUPREMA University, Juiz de Fora, Minas Gerais, Brazil aff001;  Crispi Institute of Minimally Invasive Surgery, Rio de Janeiro, Rio de Janeiro, Brazil aff002;  Department of Surgery and Anesthesia, College of Veterinary Medicine, UNIFESO University, Teresópolis, Rio de Janeiro, Brazil aff003;  Leon Cardeman Laboratory of Cytopathology, Rio de Janeiro, Rio de Janeiro, Brazil aff004;  Department of Women’s Health, Fernandes Figueira National Institute for Women, Children and Youth Health, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil aff005
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0219105

Souhrn

Infertility has been a common postoperative problem caused by peritoneal adhesions. Since several prophylactic agents have recently shown promising preliminary results, more complete studies comparing their real efficacy and safety are needed urgently. The aim of this study was to investigate and describe practical considerations of a porcine model that can be used to assess such prophylactic agents. First, 10 healthy 5½ months old female pigs (24.3–31.3 Kg) underwent a standardized laparoscopy to provoke peritubal adhesion formation without prophylactic agents. After 30 days, a second-look laparoscopy was performed to evaluate adhesions and perform adnexectomy for histopathological evaluation. Adhesions at different sites were classified by grade, for which the scores range from 0 (no adhesion) to 3 (very strong vascularized adhesions), and also by area, with scores ranging from 0 (no adhesion) to 4 (>75% of the injured area). The histopathological evaluation of the distal uterine horns, oviducts and ovaries were compared withthose from a control group of six healthy pigs with no previous surgery. Biological samples were collected to assess vitality, inflammation and renal, hepatic and hematopoietic systems. There were small (but significant) changes in serum albumin (P = 0.07), globulin (P = 0.07), C-reactive protein (P = 0.011), fibrinogen (P = 0.023) and bilirubin (P<0.01) after 30 days, but all values were within the normal range. No inflammation or abscess formation was observed, but different degrees of adhesion were identified. The estimated occurrence of adhesion (scores >0) and of strong / very strong adhesion (scores >1) was 75% (95% CI: 55–94.9) and 65% (95% CI: 45–85), respectively. The porcine model represents a useful animal platform that can be used to test the efficacy and safety of candidate prophylactic agents intended to prevent postoperative peritubal adhesions formation. We present several practical considerations and measures that can help to minimize animal suffering and avoid problems during such experiments.

Klíčová slova:

Inflammation – Ovaries – Surgical and invasive medical procedures – Prophylaxis – Swine – Laparoscopy – Pig models – Veterinary surgery


Zdroje

1. Tabibian N, Swehli E, Boyd A, Umbreen A, Tabibian JH. Abdominal adhesions: A practical review of an often overlooked entity. Ann Med Surg.2017;15:9–13. Review.

2. Torres K, Pietrzyk Ł, Plewa Z, Załuska-Patel K, Majewski M, Radzikowska E, et al. TGF-β and inflammatory blood markers in prediction of intraperitoneal adhesions. Adv Med Sci. 2018;63(2):220–223. doi: 10.1016/j.advms.2017.11.006 29223125

3. Practice Committee of American Society for Reproductive Medicine in collaboration with Society of Reproductive Surgeons. Pathogenesis, consequences, and control of peritoneal adhesions in gynecologic surgery: a committee opinion. FertilSteril. 2013;99(6):1550–1555. Review.

4. Li J, Zhu J, He T, Li W, Zhao Y, Chen Z, et al. Prevention of intra-abdominal adhesion using electrospun PEG/PLGA nanofibrous membranes. Mater SciEng C Mater Biol Appl. 2017;78:988–997.

5. Eickhoff RM, Kroh A, Rübsamen K, Heise D, Binnebösel M, Klinge U, et al. AK03, a new recombinant fibrinogenase prevents abdominal adhesions in a rat model without systemic side effects. J Surg Res. 2018;222:85–92. doi: 10.1016/j.jss.2017.09.047 29273379

6. Askari VR, Rahimi VB, Zamani P, Fereydouni N, Rahmanian-Devin P, Sahebkar AH, et al. Evaluation of the effects of Iranian propolis on the severity of post operational-induced peritoneal adhesion in rats. Biomed Pharmacother. 2018;99:346–353. doi: 10.1016/j.biopha.2018.01.068 29665643

7. de Wilde RL. Regarding "Evaluation of a Spray-type Novel Dextrin Hydrogel Adhesion Barrier under Laparoscopic Conditions in a Porcine Uterine Horn Adhesion Model". J Minim Invasive Gynecol. 2018;25(7):1311.

8. Charboneau AJ, Delaney JP, Beilman G. Fucoidans inhibit the formation of post-operative abdominal adhesions in a rat model. PLoS One. 2018;13(11):e0207797. doi: 10.1371/journal.pone.0207797 30462732

9. Choi GJ, Park HK, Kim DS, Lee D, Kang H. Effect of statins on experimental postoperative adhesion: a systematic review and meta-analysis. Sci Rep. 2018;8(1):14754. doi: 10.1038/s41598-018-33145-z 30283040

10. Ahmad G, Mackie FL, Iles DA, O'Flynn H, Dias S, Metwally M, et al. Fluid and pharmacological agents for adhesion prevention after gynaecological surgery. Cochrane Database Syst Rev. 2014; (7):CD001298. Review. doi: 10.1002/14651858.CD001298.pub4 25005450

11. Hindocha A, Beere L, Dias S, Watson A, Ahmad G. Adhesion prevention agents for gynaecological surgery: an overview of Cochrane reviews. Cochrane Database Syst Rev. 2015;1:CD011254. Review. doi: 10.1002/14651858.CD011254.pub2 25561409

12. Ahmad G, O'Flynn H, Hindocha A, Watson A. Barrier agents for adhesion prevention after gynaecological surgery. Cochrane Database Syst Rev. 2015;(4):CD000475. Review. doi: 10.1002/14651858.CD000475.pub3 25924805

13. Lin LX, Yuan F, Zhang HH, Liao NN, Luo JW, Sun YL. Evaluation of surgical anti-adhesion products to reduce postsurgical intra-abdominal adhesion formation in a rat model. PLoS One. 2017;12(2):e0172088. doi: 10.1371/journal.pone.0172088 28207824

14. Kai M, Maeda K, Tasaki M, Kira S, Nakamura S, Chino N, et al. Evaluation of a Spray-type, Novel Dextrin Hydrogel Adhesion Barrier Under Laparoscopic Conditions in a Porcine Uterine Horn Adhesion Model. J Minim Invasive Gynecol. 2018;25(3):447–454. doi: 10.1016/j.jmig.2017.09.023 29030291

15. Newman ME, Musk GC, He B. Establishment of laparoscopic live donor nephrectomy in a porcine model: techniques and outcomes in 44 pigs. J Surg Res. 2018;222:132–138. doi: 10.1016/j.jss.2017.09.042 29273364

16. Hein S, Schoeb DS, Grunwald I, Richter K, Haberstroh J, Seidl M, et al. Viability and biocompatibility of an adhesive system for intrarenalembedding and endoscopic removal of small residual fragments in minimally-invasive stone treatment in an in vivo pig model. World J Urol. 2018;36(4):673–680. doi: 10.1007/s00345-018-2188-8 29368229

17. Kilkenny C, Browne WJ, Cuthill IC, Emerson M, Altman DG. Improving bioscience research reporting: the ARRIVE guidelines for reporting animal research. PLoS Biol. 2010 Jun 29;8(6):e1000412. doi: 10.1371/journal.pbio.1000412 20613859

18. Ferland R, Mulani D, Campbell PK. Evaluation of a sprayable polyethylene glycol adhesion barrier in a porcine efficacy model. Hum Reprod. 2001;16(12):2718–23. doi: 10.1093/humrep/16.12.2718 11726601

19. Cheung JP, Tsang HH, Cheung JJ, Yu HH, Leung GK, Law WL. Adjuvant therapy for reduction of postoperative intra-abdominal adhesion formation.Asian J Surg. 2009;32(3):180–6. Review. doi: 10.1016/S1015-9584(09)60392-4 19656760

20. Trochsler M, Maddern GJ. Adhesion barriers for abdominal surgery: a sticky problem. Lancet. 2014;4;383(9911):8–10.

21. Coccolini F, Ansaloni L, Manfredi R, Campanati L, Poiasina E, Bertoli P, et al. Peritoneal adhesion index (PAI): proposal of a score for the "ignored iceberg" of medicine and surgery. World J Emerg Surg. 2013;8(1):6. doi: 10.1186/1749-7922-8-6 23369320

22. de Oliveira FMM, Pereira TRD, Demoro AVE. Punções, pneumoperitônio e inventário. In: Crispi CP, de Oliveira FMM, Damian JC Jr, de Oliveira MAP, Ribeiro PAG, editors. Tratado de endoscopia ginecológica. Rio de Janeiro: REVINTER; 2012.p.130–139.

23. Lee KC, Lu CC, Lin SE, Chang CL, Chen HH. Infiltration of Local Anesthesia at Wound Site after Single-Incision Laparoscopic Colectomy Reduces Postoperative Pain and Analgesic Usage. Hepatogastroenterology. 2015;62(140):811–816. 26902007

24. Ali S, Zarin M, Jan Z, Maroof A. Effect of Bupivacaine on Postoperative Pain after Laparoscopic Cholecystectomy. J Coll Physicians Surg Pak. 2018;28(9):663–666. doi: 10.29271/jcpsp.2018.09.663 30158029

25. Crispi CP, Crispi CP Jr, da Silva Reis PS Jr, Mendes FLF, Filgueiras MM, de Freitas Fonseca M. Hemostasis with the Ultrasonic Scalpel. JSLS. 2018;22(4). pii: e2018.00042. doi: 10.4293/JSLS.2018.00042 30626994

26. Stricker-Krongrad A, Shoemake CR, Bouchard GF. The Miniature Swine as a Model in Experimental and Translational Medicine.ToxicolPathol. 2016;44(4):612–623.

27. Diamond MP. Reduction of postoperative adhesion development.Fertil Steril. 2016;106(5):994–997.e1. doi: 10.1016/j.fertnstert.2016.08.029 27624952

28. Han ES, Scheib SA, Patzkowsky KE, Simpson K, Wang KC. The sticky business of adhesion prevention in minimally invasive gynecologic surgery. Curr Opin Obstet Gynecol. 2017;29(4):266–275. doi: 10.1097/GCO.0000000000000372 28582326

29. Malavasi L M. Suínos. In: Lumb WV; Jones:. 5ª Ed. Anestesiologia e Analgesia em Veterinária. Rio de Janeiro, RJ. Editora Roca; 2017. pp. 923–936.


Článok vyšiel v časopise

PLOS One


2020 Číslo 1
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Kurzy

Zvýšte si kvalifikáciu online z pohodlia domova

Aktuální možnosti diagnostiky a léčby litiáz
nový kurz
Autori: MUDr. Tomáš Ürge, PhD.

Všetky kurzy
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#