Sıçanlarda oluşturulan deneysel uterin horn adezyon modelinde düşük molekül ağırlıklı heparin ile oktreotidin etkileri

Ozet Amac. Dusuk molekul agirlikli heparinin postoperatif adezyon onleyici etkinligi daha once yapilan cesitli calismalarda one surulmustur. Yine Growth hormon uzerinden etki ederek Insulin like growth faktor inhibisyonuyla inflamatuar hucrelerin maturasyon ve migrasyonunu inhibe eden oktreotidin adezyon onleyici etkisi yapilan bazi arastirmalarda gosterilmistir.Bu calismada adezyon gelisiminin farkli basamaklarina etki eden dusuk molekuler agirlikli heparin ve oktreotidin tek baslarina ve kombine kullanimlari halinde adezyon olusumunu onleyici etkilerinin karsilastirilmasi amaclanmaktadir. Yontem. Calismada agirligi 250-300 gr arasinda degisen 40 adet Wistar-Albino tipi disi sican kullanildi. Sicanlar randomize olarak 10’ar sicanlik grup halinde kontrol ve 3 adet calisma gruplarina ayrildi. Adezyon modeli olusturulduktan sonra kontrol grubu disindaki diger 3 gruba dusuk molekuler agirlikli heparin, oktreotid ve dusuk molekuler agirlikli heparin ile oktreotid birlikte 14 gun sureyle uygulandi.14 gun sonra sicanlar letal doz pentobarbital ile olduruldukten sonra orta hat insizyon ile laparotomi yapilarak adezyon gelisimi degerlendirildi. Bulgular. Makroskopik olarak adezyon siddeti 3 calisma grubunda kontrol grubuna gore daha dusuk bulundu (p<0,05). Kombine grupta adezyon siddeti en az bulundu (p<0,05). Adezyon yayginligi 3 calisma grubunda da kontrol grubundan az saptandi (p<0,05). Ancak kombine grup adezyon yayginlik skoru oktreotid ve dusuk molekuler agirlikli heparin gruplarindan farksiz bulundu (p<0,05). Mikroskopik adezyon skorlamasinda ise oktreotid ve kombine grupta kontrol grubuna gore belirgin olarak dusukluk izlendi (p<0,05). Sonuc. Oktreotid ve dusuk molekuler agirlikli heparinin postoperatif intraabdominal adezyonlari onlemede ayni derecede etkin oldugunu gozlemledik. Kombine kullanimin ise izole dusuk molekuler agirlikli heparin ve oktreotid kullanimina gore adezyon siddetini engellemedeki etkinliginin daha fazla oldugu kanisina vardik. Anahtar sozcukler: Oktreotid, heparin, peritoneal adezyon Abstract Aim. Previous studies proposed that low molecular weight heparin reduces postoperative adhesion formation. Octreotide reduces the maturation and migration of inflammatory cells by inhibiting insulin like growth factor via growth hormone. Some studies showed that octreotide also reduces postoperative adhesion formation. Low molecular weight heparin and octreotide influence different stages of adhesion formation. The aim of this study was to compare the effect of low molecular weight heparin and octreotide on postoperative adhesion formation either alone or in combination. Methods. The study included 40 Wistar Albino rats weighing between 250-300 g. They were randomised to three study and one control groups each containing 10 rats. After performing an adhesion model except for the control group, low molecular weight heparin, octreotide and low molecular weight heparin plus octreotide groups received the agents for14 days. The animals were sacrificed by lethal dose pentobarbital at the end of 14 days and a mid-line laparatomy was carried out and abdominal cavity was inspected for the presence of adhesion. Results. In macroscopic evaluation, adhesion severity in the 3 study groups were lower than the control group (p<0.05). Adhesion severity was lowest in the combined group (p <0.05). Adhesion extension score of the 3 study group was lower than the control group (p <0.05). But adhesion extension score of the combined group was similar with the octreotide and low molecular weight heparin groups (p<0.05). Microsopic adhesion score of the octreotide and the combined groups were lower than the control group (p <0.05). Conclusion. Octreotide and low molecular weight heparin are equally effective for prevention of adhesion formation. However, we suggest that combination of octreotide and low molecular weight heparin is more effective than the isolated use of either low molecular weight heparin or octreotide for prevention of adhesion severity. Keywords: Octreotide, heparin, peritoneal adhesion