An intrapleural adhesion impediment model by using a membrane consisted of polyethyleneglycol after thoracotomy

Thanks to the advances in medical technology, malignancies can be detected earlier and the patients? getting benefits from surgical treatment increase. It is not rare to repeat thoracotomy more than three times due to any reason for a patient both on the world and in our clinic. Every surgical intervention results in an adhesion more or less. However; unlike abdominal surgery, while the adhesions in chest surgery do not lead to serious early period complications, they increase the morbidity and mortality in repeated thoracotomy applications, and thus create difficulty for surgeons and lengthens the operation time. Our purpose in this study was to investigate the efficiency of Prevadh®, which is an adhesion preventing agent, in a rat model.In our study, 20 adult male Wistar albino rats with a mean weight of 250-300 gr from the same colon were used. Rats were divided into three groups randomly; Sham, control and study group (A, B and C respectively). The rats in Group A underwent only left thoracotomy. In Group B, left thoracotomy was performed and an adhesion model was formed. In Group C; after performing left thoracotomy, an adhesion model was formed, and Prevadh® was placed between the pleura and lung. Rats were sacrificed on the 21st day, and the adhesions were evaluated macroscopically and histopathologically.The mean adhesion length in Group A and Group B were 3.0 ± 2.2 and 10.0 ± 2.0 cm, while it was 0.0 cm in Group C. The mean score of adhesion intensity in Group A, B and C was found to be 1.5 ± 1.0, 3.4 ± 0.7 and 1.0 ± 0.0 respectively. Though there was a statistically significance among the three groups from the point of mean adhesion length, there was a statistically significance between Group A and Group B, and Group B and Group C from the point of mean adhesion intensity (p<0.05). The mesothelium proliferation score gained statistical significance between Group A and Group C (p<0.05). There was no significance statistically among three groups from the point of pleural thickness, macrophage and mononuclear cell infiltration scores (p>0.05).According to these results, although an adhesion was detected in Group A and Group C macroscopically, no adhesion was observed in the Group C to which Prevadh® was applied. While the multiplication of mesothelium decreases in Group B, it reaches to a certain extent in Group A and Group C.In conclusion, it has been demonstrated that Prevadh®, used in clinical studies in abdominal surgery, can efficiently prevent adhesions after thoracotomy in rats. Yet, it should be supported through further clinical studies.