Efficacy of anti-adhesive barriers polyethylenglycol and dextran 70 in secondary thyroidectomy: An experimental study

This study was conducted to compare the effectiveness of two anti- adhesive barriers, dextran 70 and polyethylenglycol, for reducing adhesions after thyroidectomy in a rat model.Twenty-eight Winstar Albino rats that underwent right subtotal thyroidectomy were randomly assigned to three groups. One group received polyethylenglycol (PEG) n=10, and the other received Dextran 70 n=10, as anti-adhesive barriers. The third group was the control group n=8. At postoperative day 14, the rats were sacrified under general anesthesia, and the surgical fields were evaluated for the adhesion formation. The extent of the adhesion formation is scored from 0 (no adhesions9 to 2 (fibrous adhesions that required sharp dissection). Histopathologically, fibroblast, fibrosis, vascularization, fat necrosis, polymorphonuclear leukocytes, macrophage, lymphocyte, congestion, hemorrhage, edema, microorganism and foreign body reaction were examined.Two subjects in the control group, one in Dextran 70 and one in polyethylenglycol (PEG) group needed to be dissected sharply. Seven of 10 subjects in PEG group had no adhesions. There was significant difference between the PEG and control group (p=<0.05), whereas there was no significant difference between the Dextran 70 and control group. When examined histophologically, the criteria, showing adhesion, such as fibrosis and fibroblast were higher in the control group compared with the control group and PEG group (p=<0.05). Similarly; there was a significant difference between dextran 70 and PEG group, in favour of PEG (p=<0.05).This sudy suggests that PEG decreases the incidence of post-thyroidectomy adhesions in a rat model.Key Words: Adhesion, reoperative thyroid surgery, Dextran 70, Polyethylenglycol