THE EFFECT OF BIORESORBABLE MEMBRANE ON PORTAL VEIN BLOOD AND PERITONEAL FLUID CYTOKINE LEVELS IN THE PREVENTION OF POSTOPERATIVE ADHESIONS

Abstract

Postoperative intraabdominal adhesion formation is one of the leading problems of surgery. An understanding of the pathogenic mechanisms of adhesion formation is important for developing strategies for their prevention. In the current study, the effect of a bioresorbable membrane that isused for the prevention of postoperative intraabdominal adhesions on the portal venous blood and peritoneal fluid cytokine levels were investigated. The effectiveness of the bioresorbable membrane on adhesion prevention was evaluated in an adhesion model that was created on adult Wistar-Albino rats, A total of 30 rats which were equally divided into three different groups-control, sham, and bioresorbable membrane groups-were subjected to adhesion model operation. Portal vein blood and peritoneal fluid IL-6 and TNF-alpha levels were measured. Adhesion scores and tissue cytokine levels of the groups compared to each other. Although the portal venous blood IL-6 and TNF-alpha levels were found to be lower than the peritoneal fluid levels, that was not statistically significant. No significant fail in peritoneal fluid IL-6 and TNF-alpha levels were observed in bioresorbable membrane group compared to control group. Adhesion formation was almost completely inhibited in bioresorbable membrane group, IL-6 levels were higher in portal vein blood than the peritoneal fluid in three study groups, TNF-alpha levels were similar in portal venous blood and peritoneal fluid in bioresorbable membrane group. In conclusion; bioresorbable membrane prevents the postoperative intraabdominal adhesion formation, in bioresorbable membrane group portal vein cytokine levels were lower than the control group levels. This decrease has not been observed in peritoneal fluid samples. That was thought us that IL-6 and TNF-alpha response in adhesion formation was of intestinal origin.