Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?

COMERT, MUSTAFA; UÇAN, Hamdi Bülent; ÇAKMAK, Karadeniz Güldeniz; Emre, Ali Ugur; KARAKAYA, Kemal; Barut, Figen; Ankarali, Handan; GÜLTEKİN, FATMA AYÇA; TAŞCILAR, Öge; İRKÖRÜCÜ, Oktay

Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?

Mustafa CÖMERT, (Zonguldak Karaelmas Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Zonguldak, Türkiye)

Kemal KARAKAYA, (Zonguldak Karaelmas Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Zonguldak, Türkiye)

Figen BARUT, (Zonguldak Karaelmas Üniversitesi, Tıp Fakültesi, Patoloji Anabilim Dalı, Zonguldak, Türkiye)

Karadeniz Güldeniz ÇAKMAK, (Zonguldak Karaelmas Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Zonguldak, Türkiye)

Hamdi Bülent UÇAN, (Zonguldak Karaelmas Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Zonguldak, Türkiye)

Fatma Ayça GÜLTEKİN, (Zonguldak Karaelmas Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Zonguldak, Türkiye)

Ali Uğur EMRE, (Zonguldak Karaelmas Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Zonguldak, Türkiye)

Öge TAŞCILAR, (Zonguldak Karaelmas Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Zonguldak, Türkiye)

Oktay İRKÖRÜCÜ, (Zonguldak Karaelmas Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Zonguldak, Türkiye)

Handan ANKARALI (Düzce Üniversitesi, Tıp Fakültesi, Biyoistatistik Anabilim Dalı, Düzce, Türkiye)

Ulusal Travma ve Acil Cerrahi Dergisi

1 0

Yıl: 2010 Cilt: 16 Sayı: 5 Sayfa Aralığı: 383 - 389 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?

Öz:

AMAÇ Bu çalışmanın amacı, karın içi kullanılan Ankaferd Blood Stopper’in (ABS) periton içi yapışıklık oluşumunu arttırıp arttırmadığını ve in vivo kullanıma bağlı majör toksik etkilerini irdelemektir. GEREÇ VE YÖNTEM Bu deneysel çalışma, çekal abrazyon uygulanan sıçan modelinde Ankaferd solüsyonunun periton içi yapışıklık oluşumu üzerine etkisini değerlendirmek üzere dizayn edildi. Periton içi yapışıklıklar cerrahi uygulama sonrası 10. gün makroskopik ve histopatolojik inceleme ile belirlendi. Yan etki varlığını irdelemek için kan, akciğer ve karaciğer dokuları alındı. BULGULAR Ankaferd Blood Stopper’in kullanımı ile karın içi yapışıklık oluşumunun azaldığı görüldü. ABS uygulanmasının kan biyokimyasal incelemelerinde herhangi bir bozulmaya neden olmadığı saptandı. Ancak akciğerlerde ve bağırsakların serozal yüzeylerinde akut ve kronik enflamatuvar değişiklikler ve karaciğerde minör yapısal değişiklikler izlendi. Bu değişikliklerin hiçbiri toksik değişiklik olarak değerlendirilmedi. ABS’nin diğer etkilerinin belirlenmesi için farklı dozlarda ve farklı klinik senaryolarda ileri çalışmalara ihtiyaç vardır. SONUÇ Periton içi yapışıklık oluşumu ABS uygulanan grupta kontrol grubu ve SF grubuna kıyasla daha az görüldü. İntraperitoneal ABS kullanıma bağlı olarak herhangi bir toksik etki saptanmamakla birlikte bazı minör değişiklikler gözlenmiştir.

Anahtar Kelime:

Konular: Cerrahi

Ankaferd Blood Stopper’in karın içi kullanımı periton içi yapışıklık oluşumunu arttırır mı?

Öz:

BACKGROUND The aim of this study was to investigate whether intraabdominal Ankaferd Blood Stopper (ABS) causes increased intraabdominal adhesion formation and to determine any side effects of ABS in vivo. METHODS The present experimental study was designed to examine the effects of Ankaferd solution on peritoneal adhesion formation in a rat model of cecal abrasion. Intraperitoneal adhesions were assessed macroscopically and histopathologically on the 10th postoperative day. The possible adverse affects of ABS on liver and lung tissues were analyzed histopathologically, and blood chemistry was also evaluated. RESULTS Our study revealed that ABS reduced intraperitoneal adhesion formation in an experimental rat model. The blood chemistry was not disturbed due to ABS administration. Intraperitoneal administration of ABS led to some minor changes in the lungs and serosal surfaces of the intestines, with minor architectural changes in the liver that were not considered as toxic. Further studies with various application doses and routes with more detailed cellular analysis are thus warranted to clarify the possible pleiotropic and adverse effects of this new agent away from hemostasis. CONCLUSION There was less intraperitoneal adhesion formation in the ABS group than in the control group and saline group. Intraperitoneal administration of ABS has no toxic effects on blood chemistry or the lungs, kidneys and the liver, but it has some minor adverse effects.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Ellis H. The clinical signifcance of adhesions: focus on intestinal obstruction. Eur J Surg Suppl 1997:5-9.
2. Parker MC, Wilson MS, Menzies D, Sunderland G, Thompson JN, Clark DN, et al. Colorectal surgery: the risk and burden of adhesion-related complications. Colorectal Dis 2004;6:506-11.
3. Menzies D. Peritoneal adhesions. Incidence, cause, and prevention. Surg Annu 1992;24:27-45.
4. Menzies D, Ellis H. Intestinal obstruction from adhesionshow big is the problem? Ann R Coll Surg Engl 1990;72:60-3.
5. Kresch AJ, Seifer DB, Sachs LB, Barrese I. Laparoscopy in 100 women with chronic pelvic pain. Obstet Gynecol 1984;64:672-4.
6. Chapron C, Pierre F, Harchaoui Y, Lacroix S, Béguin S, Querleu D, et al. Gastrointestinal injuries during gynaeco- logical laparoscopy. Hum Reprod 1999;14:333-7.
7. Mecke H, Heuchmer R, Lehmann-Willenbrock E. Complications in 5,000 pelviscopies at the Kiel University Gynecologic Clinic. [Article in German] Geburtshilfe Frauenheilkd. 1996;56:449-52. [Abstract]
8. Dijkstra FR, Nieuwenhuijzen M, Reijnen MM, van Goor H. Recent clinical developments in pathophysiology, epidemiology, diagnosis and treatment of intra-abdominal adhesions. Scand J Gastroenterol Suppl 2000;232:52-9.
9. Ellis H, Moran BJ, Thompson JN, Parker MC, Wilson MS, Menzies D, et al. Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study. Lancet 1999;353:1476-80.
10. Karakaya K, Ucan HB, Tascilar O, Emre AU, Cakmak GK, Irkorucu O, et al. Evaluation of a new hemostatic agent Ankaferd Blood Stopper in experimental liver laceration. J Invest Surg 2009;22:201-6.
11. Goker H, Haznedaroglu IC, Ercetin S, Kirazli S, Akman U, Ozturk Y, et al. Haemostatic actions of the folkloric medicinal plant extract Ankaferd Blood Stopper. J Int Med Res 2008;36:163-70.
12. Aarons CB, Cohen PA, Gower A, Reed KL, Leeman SE, Stucchi AF, et al. Statins (HMG-CoA reductase inhibitors) decrease postoperative adhesions by increasing peritoneal fbrinolytic activity. Ann Surg 2007;245:176-84.
13. Grahame GR,Torchida MG, Dankewich KA, et al. Surfaceactive material in peritoneal effuent of CAPD patients. Perit Dial Bull 1985;5:109-11.
14. Dinc S, Ozaslan C, Kuru B, Karaca S, Ustun H, Alagol H, et al. Methylene blue prevents surgery-induced peritoneal adhesions but impairs the early phase of anastomotic wound healing. Can J Surg 2006;49:321-8.
15. Vrijland WW, Tseng LN, Eijkman HJ, Hop WC, Jakimowicz JJ, Leguit P, et al. Fewer intraperitoneal adhesions with use of hyaluronic acid-carboxymethylcellulose membrane: a randomized clinical trial. Ann Surg 2002;235:193-9.
16. Bae JS, Ahn SJ, Yim H, Jang KH, Jin HK. Prevention of intraperitoneal adhesions and abscesses by polysaccharides isolated from Phellinus spp in a rat peritonitis model. Ann Surg 2005;241:534-40.
17. Raşa K, Erverdi N, Karabulut Z, Renda N, Korkmaz A. The effect of methylene blue on peritoneal adhesion formation. Turk J Gastroenterol 2002;13:108-11.
18. Evans DM, McAree K, Guyton DP, Hawkins N, Stakleff K. Dose dependency and wound healing aspects of the use of tissue plasminogen activator in the prevention of intra-abdominal adhesions. Am J Surg 1993;165:229-32.
19. Holmdahl L, Risberg B, Beck DE, Burns JW, Chegini N, diZerega GS, et al. Adhesions: pathogenesis and preventionpanel discussion and summary. Eur J Surg Suppl 1997:56-62.
20. Holmdahl L, al-Jabreen M, Risberg B. Experimental models for quantitative studies on adhesion formation in rats and rabbits. Eur Surg Res 1994;26:248-56.
21. Galili Y, Ben-Abraham R, Rabau M, Klausner J, Kluger Y. Reduction of surgery-induced peritoneal adhesions by methylene blue. Am J Surg 1998;175:30-2.
22. Zühlke HV, Lorenz EM, Straub EM, Savvas V. Pathophysiology and classifcation of adhesions. [Article in German] Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir 1990:1009-16. [Abstract]
23. Duran B, Ak D, Cetin A, Guvenal T, Cetin M, Imir AG. Reduction of postoperative adhesions by N,O-carboxymethylchitosan and spermine NONOate in rats. Exp Anim 2003;52:267-72.
24. Cetin M, Duran B, Demirkoprulu N, Guvenal T, Erden O, Cetin A. Effects of diazeniumdiolates (NONOates) and methylene blue on the reduction of postoperative adhesion in rats. Gynecol Obstet Invest 2004;57:186-90.
25. Sortini D, Feo CV, Maravegias K, Carcoforo P, Pozza E, Liboni A, et al. Role of peritoneal lavage in adhesion formation and survival rate in rats: an experimental study. J Invest Surg 2006;19:291-7.
26. Kucukozkan T, Ersoy B, Uygur D, Gundogdu C. Prevention of adhesions by sodium chromoglycate, dexametha- sone, saline and aprotinin after pelvic surgery. ANZ J Surg 2004;74:1111-5.
27. van Westreenen M, van den Tol PM, Pronk A, Marquet RL, Jeekel J, Leguit P. Perioperative lavage promotes intraperitoneal adhesion in the rat. Eur Surg Res 1999;31:196-201.
28. Ozden A, Bostanci B, Sarioglu A, Taşkiran D, Tetik C. Effect of nitric oxide on postoperative adhesion formation. Eur Surg Res 1999;31:465-70.
29. Tarhan OR, Barut I, Sezik M. An evaluation of normal saline and taurolidine on intra-abdominal adhesion formation and peritoneal fbrinolysis. J Surg Res 2008;144:151-7.
30. Ellis H. The causes and prevention of intestinal adhesions. Br J Surg 1982;69:241-3.
31. Kluger Y, Weinbroum A, Ben-Avraham R, Galili Y, Klausner J, Rabau M. Reduction in formation of peritoneal adhesions by methylene blue in rats: a dose response study. Eur J Surg 2000;166:568-71.
32. Aysan E, Basak F, Kinaci E, Yanar H, Coskun H. Experimental adhesion model: effect of viscosities of fuids put in the peritoneal cavity on preventing peritoneal adhesions. Exp Anim 2007;56:349-54.

APA	COMERT M, KARAKAYA K, Barut F, ÇAKMAK K, UÇAN H, GÜLTEKİN F, Emre A, TAŞCILAR Ö, İRKÖRÜCÜ O, Ankarali H (2010). Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?. , 383 - 389.
Chicago	COMERT MUSTAFA,KARAKAYA Kemal,Barut Figen,ÇAKMAK Karadeniz Güldeniz,UÇAN Hamdi Bülent,GÜLTEKİN FATMA AYÇA,Emre Ali Ugur,TAŞCILAR Öge,İRKÖRÜCÜ Oktay,Ankarali Handan Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?. (2010): 383 - 389.
MLA	COMERT MUSTAFA,KARAKAYA Kemal,Barut Figen,ÇAKMAK Karadeniz Güldeniz,UÇAN Hamdi Bülent,GÜLTEKİN FATMA AYÇA,Emre Ali Ugur,TAŞCILAR Öge,İRKÖRÜCÜ Oktay,Ankarali Handan Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?. , 2010, ss.383 - 389.
AMA	COMERT M,KARAKAYA K,Barut F,ÇAKMAK K,UÇAN H,GÜLTEKİN F,Emre A,TAŞCILAR Ö,İRKÖRÜCÜ O,Ankarali H Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?. . 2010; 383 - 389.
Vancouver	COMERT M,KARAKAYA K,Barut F,ÇAKMAK K,UÇAN H,GÜLTEKİN F,Emre A,TAŞCILAR Ö,İRKÖRÜCÜ O,Ankarali H Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?. . 2010; 383 - 389.
IEEE	COMERT M,KARAKAYA K,Barut F,ÇAKMAK K,UÇAN H,GÜLTEKİN F,Emre A,TAŞCILAR Ö,İRKÖRÜCÜ O,Ankarali H "Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?." , ss.383 - 389, 2010.
ISNAD	COMERT, MUSTAFA vd. "Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?". (2010), 383-389.

APA	COMERT M, KARAKAYA K, Barut F, ÇAKMAK K, UÇAN H, GÜLTEKİN F, Emre A, TAŞCILAR Ö, İRKÖRÜCÜ O, Ankarali H (2010). Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?. Ulusal Travma ve Acil Cerrahi Dergisi, 16(5), 383 - 389.
Chicago	COMERT MUSTAFA,KARAKAYA Kemal,Barut Figen,ÇAKMAK Karadeniz Güldeniz,UÇAN Hamdi Bülent,GÜLTEKİN FATMA AYÇA,Emre Ali Ugur,TAŞCILAR Öge,İRKÖRÜCÜ Oktay,Ankarali Handan Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?. Ulusal Travma ve Acil Cerrahi Dergisi 16, no.5 (2010): 383 - 389.
MLA	COMERT MUSTAFA,KARAKAYA Kemal,Barut Figen,ÇAKMAK Karadeniz Güldeniz,UÇAN Hamdi Bülent,GÜLTEKİN FATMA AYÇA,Emre Ali Ugur,TAŞCILAR Öge,İRKÖRÜCÜ Oktay,Ankarali Handan Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?. Ulusal Travma ve Acil Cerrahi Dergisi, vol.16, no.5, 2010, ss.383 - 389.
AMA	COMERT M,KARAKAYA K,Barut F,ÇAKMAK K,UÇAN H,GÜLTEKİN F,Emre A,TAŞCILAR Ö,İRKÖRÜCÜ O,Ankarali H Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?. Ulusal Travma ve Acil Cerrahi Dergisi. 2010; 16(5): 383 - 389.
Vancouver	COMERT M,KARAKAYA K,Barut F,ÇAKMAK K,UÇAN H,GÜLTEKİN F,Emre A,TAŞCILAR Ö,İRKÖRÜCÜ O,Ankarali H Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?. Ulusal Travma ve Acil Cerrahi Dergisi. 2010; 16(5): 383 - 389.
IEEE	COMERT M,KARAKAYA K,Barut F,ÇAKMAK K,UÇAN H,GÜLTEKİN F,Emre A,TAŞCILAR Ö,İRKÖRÜCÜ O,Ankarali H "Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?." Ulusal Travma ve Acil Cerrahi Dergisi, 16, ss.383 - 389, 2010.
ISNAD	COMERT, MUSTAFA vd. "Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?". Ulusal Travma ve Acil Cerrahi Dergisi 16/5 (2010), 383-389.