Experimental study on prevention of postoperative peritoneal cavity adhesion by drug-loaded nanofilm during cholecystectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

FAN Qiang ^1,2 , ZHANG Longlong ² , GU Yuelei ² , QIAN Binbin ² ,  YANG Sunhu ²

1. Bengbu Medical College, Bengbu, Anhui 233003, P. R. China;
2. Department of General Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, P. R. China;

Corresponding author：

YANG Sunhu, Email: yangsh06@126.com

Keywords：

peritoneal cavity adhesion; drug-loaded nanofilm; cholecystectomy

DOI：

10.7507/1007-9424.201707004

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To observe effect of self-designed drug-loaded nanofilm in preventing postoperative peritoneal cavity adhesion during cholecystectomy in New Zealand white rabbit. Methods The 40 New Zealand white rabbits were randomly divided into blank control group, chitosan group, nanofilm group, and drug-loaded nanofilm group using random number table, the peritoneal cavity adhesions after cholecystectomy at different time (on day 7, 14, 21, and 28) were observed among these 4 groups. Results The adhesion of gallbladder forssa was serious in the blank control group and the adhesion situation had obviously improved among the other three groups, furthermore, the adhesion of the drug-loaded nanofilm group was the slightest. The adhesion score was significantly decreased in the chitosan group, the nanofilm group, or the drug-loaded nanofilm group as compared with the blank control group (P<0.05), which in the drug-loaded nanofilm group was significantly decreased as compared with the chitosan group (P<0.05) or the nanofilm group (P<0.05), which had no significant difference between the chitosan group and the nanofilm group (P>0.05). The nanofilm was degraded on day 14 after surgery and basically completely degraded on day 28 after surgery. The nanofilm degradation points had no significant differences between the nanofilm group and the drug-loaded nanofilm group at different time (P>0.05). Conclusions Drug-loaded nanofilm could prevent postoperative peritoneal cavity adhesion from physical barrier and drug therapy. It provides a new idea for prevention of peritoneal cavity adhesion after general surgery and research and development of new material to prevent peritoneal cavity adhesion in future.

Citation： FAN Qiang, ZHANG Longlong, GU Yuelei, QIAN Binbin, YANG Sunhu. Experimental study on prevention of postoperative peritoneal cavity adhesion by drug-loaded nanofilm during cholecystectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(12): 1468-1472. doi: 10.7507/1007-9424.201707004 Copy

1.	Brochhausen C, Schmitt VH, Mamilos A, et al. Expression of CD68 positive macrophages in the use of different barrier materials to prevent peritoneal adhesions—an animal study. J Mater Sci Mater Med, 2017, 28(1): 15.
2.	Boland GM, Weigel RJ. Formation and prevention of postoperative abdominal adhesions. J Surg Res, 2006, 132(1): 3-12.
3.	Hamming JF, Bonsing BA. Adhesiolysis during abdominal surgery: substantial risks. Ned Tijdschr Geneeskd, 2013, 157(7): A5928.
4.	Parker MC, Wilson MS, van Goor H, et al. Adhesions and colorectal surgery—call for action. Colorectal Dis, 2007, 9 Suppl 2: 66-72.
5.	Gutt CN, Oniu T, Schemmer P, et al. Fewer adhesions induced by laparoscopic surgery? Surg Endosc, 2004, 18(6): 898-906.
6.	Atta HM. Prevention of peritoneal adhesions: a promising role for gene therapy. World J Gastroenterol, 2011, 17(46): 5049-5058.
7.	陈志新. 腹腔粘连的形成及术后预防. 中国普外基础与临床杂志, 2003, 10(5): 509-510.
8.	田易军, 胡森, 包呈梅, 等. 卡巴胆碱预防术后腹腔粘连的实验研究. 中国普外基础与临床杂志, 2008, 15(6): 435-439.
9.	Pan G, Liu S, Zhao X, et al. Full-course inhibition of biodegradation-induced inflammation in fibrous scaffold by loading enzyme-sensitive prodrug. Biomaterials, 2015, 53: 202-210.
10.	Cheng L, Sun X, Zhao X, et al. Surface biofunctional drug-loaded electrospun fibrous scaffolds for comprehensive repairing hypertrophic scars. Biomaterials, 2016, 83: 169-181.
11.	Jiang S, Zhao X, Chen S, et al. Down-regulating ERK1/2 and SMAD2/3 phosphorylation by physical barrier of celecoxib-loaded electrospun fibrous membranes prevents tendon adhesions. Biomaterials, 2014, 35(37): 9920-9929.
12.	Vetere PF, Lazarou G, Apostol R, et al. Postoperative adhesion formation in a rabbit model: monopolar electrosurgery versus ultrasonic scalpel. JSLS, 2015, 19(2). pii: e2015.00018.
13.	Atilgan R, Kuloglu T, Ozkan ZS, et al. Evaluation of vitamin C and vitamin E for prevention of postoperative adhesion: a rat uterine horn model study. J Obstet Gynaecol Res, 2015, 41(3): 418-423.
14.	Xia Y, Zhu YZ, Xu C. Hydrogen sulfide prevents postoperative adhesion in a rat uterine horn model. Taiwan J Obstet Gynecol, 2017, 56(1): 46-50.
15.	Brüggmann D, Tchartchian G, Wallwiener M, et al. Intra-abdominal adhesions: definition, origin, significance in surgical practice, and treatment options. Dtsch Arztebl Int, 2010, 107(44): 769-775.
16.	Brochhausen C, Schmitt VH, Rajab TK, et al. Mesothelial morphology and organisation after peritoneal treatment with solid and liquid adhesion barriers—a scanning electron microscopical study. J Mater Sci Mater Med, 2012, 23(8): 1931-1939.
17.	Maciver AH, McCall M, James Shapiro AM. Intra-abdominal adhesions: cellular mechanisms and strategies for prevention. Int J Surg, 2011, 9(8): 589-594.
18.	Diamond MP, Wexner SD, diZereg GS, et al. Adhesion prevention and reduction: current status and future recommendations of a multinational interdisciplinary consensus conference. Surg Innov, 2010, 17(3): 183-188.
19.	Chang JJ, Lee YH, Wu MH, et al. Electrospun anti-adhesion barrier made of chitosan alginate for reducing peritoneal adhesions. Carbohydrate Polymers, 2012, 88(4): 1304-1312.
20.	Wei CZ, Hou CL, Gu QS, et al. A thermosensitive chitosan-based hydrogel barrier for post-operative adhesions' prevention. Biomaterials, 2009, 30(29): 5534-5540.
21.	Li L, Wang N, Jin X, et al. Biodegradable and injectable in situ cross-linking chitosan-hyaluronic acid based hydrogels for postoperative adhesion prevention. Biomaterials, 2014, 35(12): 3903-3917.
22.	Zhu L, Peng L, Zhang YQ. The processing of chitosan and its derivatives and their application for postoperative anti-adhesion. Mini Rev Med Chem, 2015, 15(4): 330-337.
23.	Li F, Fan C, Zeng B, et al. Celecoxib suppresses fibroblast proliferation and collagen expression by inhibiting ERK1/2 and SMAD2/3 phosphorylation. Molecular medicine reports, 2012, 5(3): 827-831.

1. Brochhausen C, Schmitt VH, Mamilos A, et al. Expression of CD68 positive macrophages in the use of different barrier materials to prevent peritoneal adhesions—an animal study. J Mater Sci Mater Med, 2017, 28(1): 15.
2. Boland GM, Weigel RJ. Formation and prevention of postoperative abdominal adhesions. J Surg Res, 2006, 132(1): 3-12.
3. Hamming JF, Bonsing BA. Adhesiolysis during abdominal surgery: substantial risks. Ned Tijdschr Geneeskd, 2013, 157(7): A5928.
4. Parker MC, Wilson MS, van Goor H, et al. Adhesions and colorectal surgery—call for action. Colorectal Dis, 2007, 9 Suppl 2: 66-72.
5. Gutt CN, Oniu T, Schemmer P, et al. Fewer adhesions induced by laparoscopic surgery? Surg Endosc, 2004, 18(6): 898-906.
6. Atta HM. Prevention of peritoneal adhesions: a promising role for gene therapy. World J Gastroenterol, 2011, 17(46): 5049-5058.
7. 陈志新. 腹腔粘连的形成及术后预防. 中国普外基础与临床杂志, 2003, 10(5): 509-510.
8. 田易军, 胡森, 包呈梅, 等. 卡巴胆碱预防术后腹腔粘连的实验研究. 中国普外基础与临床杂志, 2008, 15(6): 435-439.
9. Pan G, Liu S, Zhao X, et al. Full-course inhibition of biodegradation-induced inflammation in fibrous scaffold by loading enzyme-sensitive prodrug. Biomaterials, 2015, 53: 202-210.
10. Cheng L, Sun X, Zhao X, et al. Surface biofunctional drug-loaded electrospun fibrous scaffolds for comprehensive repairing hypertrophic scars. Biomaterials, 2016, 83: 169-181.
11. Jiang S, Zhao X, Chen S, et al. Down-regulating ERK1/2 and SMAD2/3 phosphorylation by physical barrier of celecoxib-loaded electrospun fibrous membranes prevents tendon adhesions. Biomaterials, 2014, 35(37): 9920-9929.
12. Vetere PF, Lazarou G, Apostol R, et al. Postoperative adhesion formation in a rabbit model: monopolar electrosurgery versus ultrasonic scalpel. JSLS, 2015, 19(2). pii: e2015.00018.
13. Atilgan R, Kuloglu T, Ozkan ZS, et al. Evaluation of vitamin C and vitamin E for prevention of postoperative adhesion: a rat uterine horn model study. J Obstet Gynaecol Res, 2015, 41(3): 418-423.
14. Xia Y, Zhu YZ, Xu C. Hydrogen sulfide prevents postoperative adhesion in a rat uterine horn model. Taiwan J Obstet Gynecol, 2017, 56(1): 46-50.
15. Brüggmann D, Tchartchian G, Wallwiener M, et al. Intra-abdominal adhesions: definition, origin, significance in surgical practice, and treatment options. Dtsch Arztebl Int, 2010, 107(44): 769-775.
16. Brochhausen C, Schmitt VH, Rajab TK, et al. Mesothelial morphology and organisation after peritoneal treatment with solid and liquid adhesion barriers—a scanning electron microscopical study. J Mater Sci Mater Med, 2012, 23(8): 1931-1939.
17. Maciver AH, McCall M, James Shapiro AM. Intra-abdominal adhesions: cellular mechanisms and strategies for prevention. Int J Surg, 2011, 9(8): 589-594.
18. Diamond MP, Wexner SD, diZereg GS, et al. Adhesion prevention and reduction: current status and future recommendations of a multinational interdisciplinary consensus conference. Surg Innov, 2010, 17(3): 183-188.
19. Chang JJ, Lee YH, Wu MH, et al. Electrospun anti-adhesion barrier made of chitosan alginate for reducing peritoneal adhesions. Carbohydrate Polymers, 2012, 88(4): 1304-1312.
20. Wei CZ, Hou CL, Gu QS, et al. A thermosensitive chitosan-based hydrogel barrier for post-operative adhesions' prevention. Biomaterials, 2009, 30(29): 5534-5540.
21. Li L, Wang N, Jin X, et al. Biodegradable and injectable in situ cross-linking chitosan-hyaluronic acid based hydrogels for postoperative adhesion prevention. Biomaterials, 2014, 35(12): 3903-3917.
22. Zhu L, Peng L, Zhang YQ. The processing of chitosan and its derivatives and their application for postoperative anti-adhesion. Mini Rev Med Chem, 2015, 15(4): 330-337.
23. Li F, Fan C, Zeng B, et al. Celecoxib suppresses fibroblast proliferation and collagen expression by inhibiting ERK1/2 and SMAD2/3 phosphorylation. Molecular medicine reports, 2012, 5(3): 827-831.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Experimental study on prevention of postoperative peritoneal cavity adhesion by drug-loaded nanofilm during cholecystectomy

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