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İNTRAPERİTONEAL ADEZYONLARIN ÖNLENMESİNDE FOSFOLİPİD SOLÜSYONLARININ ETKİLERİ

PHOSPHOLIPID SOLUTIONS FOR PREVENTION OF INTRAPERITONEAL ADHESIONS

Journal Name:

  • Selçuk Tıp Dergisi

Publication Year:

  • 2008

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
Aim: In this study we aimed to analyze effects of phospholipid solutions (preventing adhesions by increasing slipperiness between damaged surfaces and detaching them) during peritoneal reepitelization. Material and Method: Thirty Wistar Albino type rats divided in two groups. Caecum serosa was damaged using sterile gauzes to achive light serosal haemorrhagy and 1 cm2 of periton excised from right side of abdominal wall in all rats.Group I was applied 3 ml %0.9 NaCl and Group II was applied phospholipid solution (Fresnius Kabi - Deustchland) intrabdominally before closure. Rats sacrified at postopertive 10th day. After macroscopically examining adhesions, adhesion sur¬faces were calculated with a calibration scale. In microscopic examination lymphocytes, plasma cells, polymorphonuclear cells, histiocytes and fibroblasts were marked and counted with Clemex Image Analysis system. Results: In phospholipid group there was a significant decrease in adhesion for-mation compared to control group macroscopically. The decrease in adhesion formation was sta-tistically significant (p<0.05). There were also significant differences between two groups in micro-scopically observed fibroblast and PMNL ratios and this difference was also statistically significant. Conclusions: Usage of phopholipid solutions decreases postoperative adhesions. Application of phospholipid solutions is a cost-effective method for preventing consequent operations for intraab-dominal adhesions
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Abstract (Original Language): 
Amaç: Çalışmamızda fosfolipid solüsyonlarının peritoneal reepitelizasyon sırasında hasarlı yüzeyler arasında kayganlık sağlayarak ve hasarlı yüzeyleri birbirinden ayırarak adezyon oluşumunu önlemedeki etkilerini incelemeyi planladık. Materyal ve Metod: Çalışmada 30 adet Wistar Albino cinsi dişi rat 2 gruba ayrıldı. Bütün ratlara steril spançlar ile çekum serozasında noktasal hemoraji oluşturacak şekilde serozal hasar oluşturuldu, sağ taraftan 1 cm2 genişliğinde periton tabakası eksize edilerek aynı girişim uygulandı. Grup I (kontrol): 3 ml %09'luk NaCl, Grup II (fosfolipid): Abdomen kapatılmadan önce 75 mg/kg dozda % 10'luk fosfolipid solusyonu (Fresenius Kabi Deutschland) intraperitoneal verilerek abdomen kapatıldı. Postoperatif 10. günde ratlar sakrifiye edildi. Adezyon alanları makroskopik olarak incelendikten sonra yapışıklık oluşturmuş alanlar kalibrasyon cetveli kul¬lanılarak hesaplandı. Mikroskopik incelemede lenfositler, plazma hücreleri, polimorfonükleer hücre¬ler, histiyositler ve fibroblastlar farklı farklı işaretlenerek Clemex Image Analizi sistemi ile otomatik olarak sayıldı. Bulgular: Çalışmamızda fosfolipid grubunda makroskopik olarak adezyon oluşumun¬da kontrol grubuna göre belirgin bir azalma tespit edildi. Bu fark istatiksel olarak anlamlı bulundu (p<0,05). Mikroskopik olarak fibroblast ve PMNL oranlarında her iki grup arasında farklılık saptanmış ve bu farklılık istatistiksel olarak anlamlı bulunmuştur (p<0,05). Sonuç: Çalışmamızın sonuçlarına göre kullanılan fosfolipid solüsyonu postoperatif adezyonu azaltmaktadır. Maliyetinin düşük olması ve kolay uygulanabilmesi nedeniyle fosfolipid solusyonlarının postoperatif intraperitoneal adezyonları önlemede etkili olacağını düşünmekteyiz.
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  • 2
91-96
  • Turkish

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