Effect of the use of intraperitoneal n-acetylcysteine on postoperative adhesions after abdominal intervention

Postoperative intraabdominal adhesions are important health problems. In this study we researched the effect of N-acetylcysteine (NAC) local administration on postoperative intraabdominal adhesion formation in the rat models. We used 20 female Wistar Albino rats which were 5-7 months old and 160-300 gr. Rats were divided into 2 equal groups; Group 1 was administered 2 cc saline solution after caecal abrasion, Group 2 was administered 150 mg/kg NAC (completed to 2 cc with saline solution). Rats were fed orally after the surgery. Rats were sacrificed on postoperative tenth day and were examined macroscopically and microscopically for the adhesion formation. Intraperitoneal adhesion formation was scored blinded with Evans model. In Group 1 there were no rats without adhesion, 3 rats had adhesions can be separated simply, 4 rats had adhesions can beseparated by traction and 3 rats had adhesions needed dissection. In Group 2, 6 rats had no adhesions, 4 rats had adhesions can be separated simply there were no rats with adhesions needed traction or dissection. In histopathologic examination, all of the Group 1 rats had interstitial fibrosis and inflammatory cell reaction. Three rats had minimal, 6 rats had moderate and 1 rat had dense fibrosis. In this group, 6 rats had mild, 2 rats had moderate and 2 rats had severe inflammatory cell reaction. In Group 2, 4 rats had no interstitial fibrosis or inflammatory cell reaction. Six rats had mild inflammatory cell reaction and interstitial fibrosis. None of the rats of Group 2 had severe inflammatory cell reaction or dense interstitial fibrosis. Macroscopic adhesion formation and microscopic inflammatory cell reaction and interstitial fibrosis formation after surgery were evaluated between sham group and the NAC group and was found in the benefit the NAC group (p<0.05, p<0.05, p<0.05). In this experimental study we showed that the intraperitoneal single dose use of NAC has decreased the postoperative intraabdominal adhesions. NAC can be a promising drug for decreasing the postoperative adhesions.