가토 모델에서 복강경 수술 시 전기방사 나노섬유 유착방지제의 효과 및 안전성

• Published in: Annals of surgical treatment and research Vol. 76; no. 2; pp. 73 - 80
• Main Authors: 이영우(Young Woo Lee), 추보영(Boyoung Chu), 이윤기(Yun Gee Lee), 김남현(Nam Hyun Kim), 김준호(Jun Ho Kim), 김광일(Kwang Il Kim), 권성원(Sung Won Kwon)
• Format: Journal Article
• Language: Korean
• Published: 대한외과학회 01.02.2009
• Subjects: 일반외과학; 유착 방지; 복강경; Rabbit model; Laparoscopy; Adhesion prevention; Nanofibers; 나노섬유; 가토 모델
• ISSN: 2288-6575; 2288-6796

Purpose: Most recently developed anti-adhesive membranes are not suitable for laparoscopic surgery due to weak mechanical properties or adhesive characteristics. To overcome these problems, we prepared electrospun bioabsorbable nanofibrous poly (lactic-co-glycolic acid)-based membranes as an adhesion barrier. We evaluated the efficacy and safety of this material for laparoscopic surgery in a rabbit model. Methods: A standardized laparoscopic surgical trauma was made on the rabbit’s uterine horn and adjacent abdominal wall to induce adhesion formation. The injured uterus was covered by a nanofibrous barrier or it was left untreated (the negative control group) (each group: n=14). To evaluate acute toxicity of this material, blood sampling was made 3 and 7 days after laparoscopic surgery to check liver and renal function. Three weeks after laparoscopy, a second look laparoscopy was performed and the adhesions were scored according to Blauer's scoring system. Tissue between abdominal wall and uterus was obtained to examine microscopically. Liver, kidney and uterus were harvested to examine chronic toxicity. Results: 36.4% of the nanofiber treatment group and 70% of the untreated control group showed severe adhesions (grade＞3) after laparoscopic surgery but failed to get a statistical significance (P=0.198). Acute and chronic toxicity induced by this material were not noted in the blood and tissue exam. Conclusion: This study showed that nanofiber barrier seems to be a novel resorbable biomaterial for the reduction of postoperative adhesions. Easy placement and handling of this material make these membranes potentially successful candidates for laparoscopic surgery. But further study is needed to get a statistical significance. Purpose: Most recently developed anti-adhesive membranes are not suitable for laparoscopic surgery due to weak mechanical properties or adhesive characteristics. To overcome these problems, we prepared electrospun bioabsorbable nanofibrous poly (lactic-co-glycolic acid)-based membranes as an adhesion barrier. We evaluated the efficacy and safety of this material for laparoscopic surgery in a rabbit model. Methods: A standardized laparoscopic surgical trauma was made on the rabbit’s uterine horn and adjacent abdominal wall to induce adhesion formation. The injured uterus was covered by a nanofibrous barrier or it was left untreated (the negative control group) (each group: n=14). To evaluate acute toxicity of this material, blood sampling was made 3 and 7 days after laparoscopic surgery to check liver and renal function. Three weeks after laparoscopy, a second look laparoscopy was performed and the adhesions were scored according to Blauer's scoring system. Tissue between abdominal wall and uterus was obtained to examine microscopically. Liver, kidney and uterus were harvested to examine chronic toxicity. Results: 36.4% of the nanofiber treatment group and 70% of the untreated control group showed severe adhesions (grade＞3) after laparoscopic surgery but failed to get a statistical significance (P=0.198). Acute and chronic toxicity induced by this material were not noted in the blood and tissue exam. Conclusion: This study showed that nanofiber barrier seems to be a novel resorbable biomaterial for the reduction of postoperative adhesions. Easy placement and handling of this material make these membranes potentially successful candidates for laparoscopic surgery. But further study is needed to get a statistical significance. KCI Citation Count: 9