The effects of intraperitoneal chemotherapeutic agents on adhesion formation

Purpose: Intra-abdominal adhesions are a major complication of healing. Furthermore these adhesions may cause morbidity and sometimes mortality for patients, and also are a financial burden to the health system. Materials and Methods: Cecum abrasion was performed in all rats and solutions containing saline to group 1, 5-fluorouracil to group 2, cisplatin to group 3, paclitaxel to the group 4, and mitomycin-C were administered into the abdomen of the groups, respectively. The intra-abdominal adhesions were scored after the macroscopic evaluation. Results: Among the chemotherapeutic drugs, paclitaxel significantly increases occurring of intra-abdominal adhesions in comparison with the control group and the other drugs according to the evaluation of scoring and statistical studies. Conclusion: It is suggested to use the drugs which have a proven anti-adhesion feature or barriers to the patients who are going to be applied intraperitoneal chemotherapy with paclitaxel

Intra-abdominal adhesions; Intraperitoneal chemotherapy; Cytoreductive surgery.

[1] Attard J.A., MacLean A.R.: “Adhesive small bowel obstruction: epidemiology, biology and prevention”. Can. J. Surg., 2007, 50, 291.

[2] Alataş E., Kafkaslı A.: “Adezyonların oluşumunun önlenmesinde intraperitoneal Flavanoid (Daflon 500 mg) tedavisinin rolü”. J. Turgut. Ozal. Med. Cent., 1999, 6, 1.

[3] Günay C., Sağlıyan A., Yaman İ.: “Ratlarda deneysel olarak oluşturulan intraabdominal adezyonların önlenmesinde aprotinin ile metilen mavisinin etkinliğinin karşılaştırılması”. Fırat Üniversitesi Sağlık Bilimleri Dergisi., 2005, 19, 51.

[4] Jayne D.G., Fook S., Loi C., Seow-Choen F.: “Peritoneal carcinomatosis from colorectal cancer”. Br. J. Surg., 2002, 89, 1545.

[5] Sadeghi B, Arvieux C, Glehen O, Beaujard AC, Rivoire M, Baulieux J, et al.: “Peritoneal carcinomatosis from non-gynecologic malignancies: results of the EVOCAPE 1 multicentric prospective study”.

Cancer, 2000, 88, 358.

[6] Pilati P, Mocellin S, Rossi CR, Foletto M, Campana L, Nitti D, et al.: “Cytoreductive surgery combined with hyperthermic intraperitoneal intraoperative chemotherapy for peritoneal carcinomatosis arising from colon adenocarcinoma”. Ann. Surg. Oncol., 2003, 10, 508.

[7] Sugarbaker P.H.: “A curative approach to peritoneal carcinomatosis from colorectal cancer”. Semin. Oncol., 2005, 32, 868.

[8] Ihemelandu C.U., Shen P., Stewart J.H., Votanopoulos K., Levine E.A.: “Management of peritoneal carcinomatosis from colorectal cancer”. Semin. Oncol., 2011, 38, 568.

[9] Asbun H.J., Hughes S.: “Management of recurrent and metastatic colorectal carcinoma”. Surg. Clin. North Am., 1993, 73, 145.

[10] Karadayi K., Turan M., Karadayi S., Alagozlu H, Kilickap S, Buyulcelik A, et al.: “Cytoreductive Surgery Followed by Hyperthermic Intraperitoneal Chemotherapy: Morbidity and Mortality Analysis of Our Patients”. Turkiye klinikleri tip bilimleri dergisi, 2012, 32, 162.

[11] Ozel H., Avsar F.M., Topaloglu S., Sahin M.: “Induction and assessment methods used in experimental adhesion studies”. Wound Repair Regen., 2005, 13, 358.

[12] Nair S.K., Bhat K.I., Aurora L.A.: “Role of proteolytic enzyme in the prevention of postoperative adhesions”. Arch. Surg., 1974, 108, 849.

[13] Ryan C.K., Sax H.C.: “Evaluation of a carboxymethylcellulose sponge for prevention of postoperative adhesions”. Am. J. Surg.: 1995, 169, 154.

[14] Diamond M.P.: “Surgical aspects of infertility”. In: Sciarra J.E., (ed). Gynecology and Obstetrics. Philadelphia: Harper & Row, 1995, 1.

[15] Linksy C.B., Diamond M.P., Cunningham T., Constantine B, DeCherney AH, diZerega GS.: “Adhesion reduvtion in the rabbit uterine horn model using an absorbable barrier, TC-7”. J. Reprod. Med., 1987, 32, 17.

[16] Menzies D., Ellis H.: “Intestinal obstruction from adhesions how big is the problem?”. Ann. R. Coll. Surg. Engl., 1990, 72, 60.

[17] Shikata J.I., Yamaoka I.: “The role of topically applied dexamethasone in preventing peritoneal adhesions: experimental and clinical studies”. World J. Surg., 1977, 1, 389.

[18] Sugarbaker P.H., Jablonski K.A.: “Prognostic features of 51 colorectal and 130 appendiceal cancer patients with peritoneal carcinomatosis treated by cytoreductive surgery and intraperitoneal chemotherapy”. Ann. Surg., 1995, 221, 124.

[19] Schneebaum S., Arnold M.W., Staubus A., Young DC., Dumond D., Martin EW Jr.: “Intraperitoneal hyperthermic perfusion wifh mitomycin C for colorectal cancer with peritoneal metastases”. Ann. Surg. Oncol., 1996, 3, 44.

[20] Füzün M., Sökmen S., Terzi C., Canda AE.: “Cytoreductive approachto peritoneal carcinomatosis originated from color ectal cancer: Turkish experience”. Acta Chir. Iugosl., 2006, 53, 17.

[21] Sugarbaker P.H.: “Intraperitoneal chemotherapy and cytoreductive surgery for the prevention and treatment of peritoneal carcinomatosis and sarcomatosis”. Dis. Colon. Rectum, 1994, 37, 115.

[22] Markman M.: “İntraperitoneal chemotherapy”. Sem. Oncol., 1991, 18, 248.

[23] Demirturk F., Aytan H., Caliskan A.C.: “Comparison of the adhesion scoring systems used in animal models and assessment of interobserver reproducibility”. Aust. N. Z. J. Obstet. Gynaecol., 2006, 46, 356.

[24] Cascales-Campos P.A., Gil J., Feliciangeli E., Gil E, González-Gil A, López V., et al.: “The role of hyperthermic intraperitoneal chemotherapy using paclitaxel in platinum-sensitive recurrent epithelial ovarian cancer patients with microscopic residual disease after cytoreduction”. Ann. Surg. Oncol., 2015, 22, 987.

[25] Helm J.H., Miura J.T., Glenn J.A. Marcus RK., Larrieux G., Jayakrishnan TT., et al.: “Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma: a systematic review and meta-analysi”. Ann. Surg. Oncol., 2015, 22, 1686.

[26] Müller S.A., Treutner K.H., Jörn H., Anurov M., Oettinger AP., Schumpelick V.: “Adhesion prevention comparing liquid and solid barriers in the rabbit uterine horn model”. Eur. J. Obstet. Gynecol. Reprod. Biol., 2005, 120, 222.