Effects of systemic rapamycine administration on postoperative peritoneal adhesions in rats

Purpose: The formation of postoperative adhesions is a common problem in abdominal surgery that may lead to serious complications that resulting in considerable morbidity and economic loss. The consequences of intra abdominal adhesions after laparotomy include small bowel obstruction, infertility, and chronic pelvic pain. Postoperative adhesions also create significant problems in re-operative surgical procedures because lengthen the time to re-enter to the abdomen. It limit the exposure of portions of the abdominal cavity and increase the risk for inadvertent enterotomies. Adhesions increase medical costs when these patients require medical or surgical treatments. In this study we investigated the effect of rapamycin on abdominal adhesions.Material and Method: In our study we used male albino-Wistar rats weighing between 300-350g. Two groups, each containing seven rats for systemic rapamycin, and control groups have been constituted. 3 days before of wounding rats were treated with 1 mg/kg/day sirolimus . A peritoneal adhesion model created on each rat. On postoperative 7. day all rats were surgically explored and evaluated with a macroscopic adhesion scoring system by a surgeon who is blinded to the study. We take the blood samples for counting the blood sirolimus level. In rats which developed adhesions, peritoneal bands excised with affected organs, and in rats with no adhesion, ceacal anterior wall and parietal periton with whole abdominal wall including all layers of except from skin excised for pathologic evaluation. Stastical analysis was performed using Mann Whitney u test.Results: After macroscopic evaluation scores assessed, there were statistically significant difference between two groups ( systemic rapamycin and control) (p=0.035). After histopatologic exam there were no statistically significant difference between systemic rapamycin groups and control (p=0.790). Also in systemic rapamicin group there where no statistically significant differences in macroscopic and histopathologic adhesion scores with the blood sirolimus levels.(p=0.449,p=0,618)Conclusion: This study showed that systemic rapamycin administration may prevent the formation of postoperative intraabdominal adhesions.Key Words: Postoperative intraabdominal adhesion, systemic rapamycin