Adhesion formation from release of dermoid contents in the peritoneal cavity and effect of copious lavage: A prospective, randomized, blinded, controlled study in a rabbit model
Adhesion formation from release of dermoid contents in the peritoneal cavity and effect of copious lavage: A prospective, randomized, blinded, controlled study in a rabbit model
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DOI：
10.1016/s0015-0282(16)58225-9
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发表时间：
1996-04-01
影响因子：
6.7
通讯作者：
Guido, R
中科院分区：
文献类型：
--
作者：
Fiedler, EP;KanbourShakir, A;Guido, R
目的：在兔模型中，确定腹膜暴露于皮样囊肿物是否会产生高于对照水平的炎症和粘连，以及生理盐水灌洗是否会降低腹膜反应的程度。设计：一项关于粘连形成的前瞻性、随机、盲法对照研究。30只新西兰白兔随机分为5组：[1]腹腔镜组，[1]腹腔镜组，[2]腹腔镜组，[2]腹腔镜组，[2]腹腔镜组，[3]生理盐水灌洗组，[4]腹腔镜组，[5]单纯腹腔镜组。主要观察指标：首次腹腔镜术后6周，通过目测评分(0~15分)和组织学评分(0~24分)，对炎症和粘连进行评分。结果：1、2、3、4、5组的临床评分分别为13.85+/-0.55、2.90+/-1.15、0+/-0、1.50+/-1.00和0+/-0，组织学评分分别为16.83+/-1.22、7.33+/-1.76、0+/-0、0+/-0和0+/-0。经非参数检验，两组间临床和组织学评分有显著差异。结论：皮样物质可引起显著腹膜炎。临床评估结果表明，生理盐水灌洗可使炎症和粘连形成接近对照水平。然而，组织学评估的结果表明，灌洗导致的炎症减轻可能没有临床评估发现的那么显著。
Objectives: To determine, in a rabbit model, whether peritoneal exposure to dermoid cyst material produces inflammation and adhesions above control levels and whether saline lavage reduces the degree of peritoneal reaction.Design: A prospective, randomized, blinded, controlled study of adhesion formation. Thirty New Zealand white female rabbits were assigned randomly to five experimental groups: [1] laparoscopy with intraperitoneal injection of human dermoid material, [2] laparoscopy with intraperitoneal injection of human dermoid material and subsequent lavage to clear all visible dermoid material, [3] laparoscopy with saline lavage, [4] laparoscopy with intraperitoneal injection of human follicular fluid (antigenic control), and [5] laparoscopy alone.Main Outcome Measures: Six weeks after initial laparoscopy, inflammation and adhesions were scored in several categories via visual assessment (range 0 to 15) and histologic microscopic evaluation (range 0 to 24). Data were evaluated using Kruskal-Wallis and Mann-Whitney U nonparametric tests.Results: For groups 1, 2, 3, 4, and 5, respectively, mean +/- SEM total inflammation-adhesion scores were 13.85 +/- 0.55, 2.90 +/- 1.15, 0 +/- 0, 1.50 +/- 1.00, and 0 +/- 0 for clinical evaluation and 16.83 +/- 1.22, 7.33 +/- 1.76, 0 +/- 0, 0 +/- 0, and 0 +/- 0 for histologic evaluation. Using nonparametric tests, significant differences were found between groups in clinical and histologic scores.Conclusions: Dermoid material produces a significant peritonitis. Results of the clinical evaluation demonstrate that saline lavage brings inflammation and adhesion formation close to control levels. However, results of the histologic evaluation suggest that the decrement in inflammation as a result of lavage may be less dramatic than that found by clinical evaluation.