Arung Kalau
Accepted Abstracts: Surgery Curr Res
Background: Adhesion formation is common after abdominal surgery. The incidence and severity of adhesionformation following open or laparoscopic surgery remain controversial. The role of CO 2 pneumoperitoneum is also widely discussed. This study aimed to compare adhesion formation following peritoneal injury by electrocoagulation performed through open or laparoscopic procedures in a rat model. Materials and Methods: Sixty male rats were randomized to undergo a 1.5 cm peritoneal injury with unipolarcautery under general anesthesia: open surgery (Group A, n=20), laparoscopic surgery with CO 2 pneumoperitoneum (Group B, n=20), and laparoscopic surgery with air pneumoperitoneum (Group C, n=20). Duration of the procedures was fixed at 90 minutes in all groups, and pneumoperitoneum pressure was kept at 10 mm Hg. Ten days later, the animals underwent a secondary laparotomy to score peritoneal adhesions using qualitative and quantitative parameters. Results: Forty-five rats developed at least one adhesion: 95% in Group A, 83% in Group B, and 55% in Group C (P<.01; Group C versus Group A, P<.01). According to number, thickness, tenacity, vascularization, extent, type, and grading according to the Zu ̈hkle classification, no significant difference was observed between Groups A and B. The distribution of adhesions after open surgery was significantly different than after laparoscopic surgery (P<.001). It is interesting that Group C rats developed significantly fewer adhesions at the traumatizedsite, and their adhesions had less severe qualitative scores compared with those after open surgery (P<.01). Conclusion: In this animal model, CO 2 laparoscopic surgery did not decrease the formation of postoperativeadhesion, compared with open surgery. The difference with the animals operated on with air pneumoperitoneum emphasizes the role of CO 2 in peritoneal injury leading to adhesion formation.
