PP29 Anti-Adhesive Gel Decreases Intra-Abdominal Adhesions After Laparotomy: An Experimental Prospective Study

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V. Mishalov, P. Byck, I. Leshchyshyn, V. Golinko, O. Okhotska, D. Unukovych

19:28 - 19:34h at Margrit Room

Categories: Gastrointestinal Surgery, Poster Session , Robotic and Minimal Invasive Surgery

Session: Poster (P2) - Gastrointestinal Surgery / Minimal Invasive

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Background
The aim of this study was to evaluate the effects of anti-adhesive gel on adhesion process and overall complications after bowel resection and abdominal wall repair with polypropylene mesh.

Material and Methods
Fifty-two Wistar rats that have been previously operated with laparotomy and ileum resection with end-to-end anastomosis were eligible for the study. All anastomoses were performed with sutures by one surgeon (PB). Approximately one month after the surgery, all rats were reoperated with primary anastomosis resection and new anastomosis formation (Group I, n=16). In Group II (n=19), a PML1 mesh was used for "sublay" abdominal wall repair, and in Group III (n=17) both PML1 mesh and an anti-adhesive gel was used.

Result
Groups were not statistically different at baseline. At the follow-up, adhesive process in abdominal cavity was statistically significant higher in Group II compared to Group I (p>0,001). There was positive correlation between mesh implantation and adhesive process (p=0,489, p=0,003). In Group III there was a statistically lower spread of adhesion than in Group II (p>0,001) as well as lower severity compared to Group I (p=0.038) and Group II (p=0.013). Infections in Group I, II, and III were in 4/16 (25%), 6/19 (31.6%) an 11/17 (64.7%) cases, respectively, indicating statistically worse results (p>0,001) in Group III.

Conclusion
Anti-adhesive gel application significantly reduced the spread and severity of intra-abdominal adhesions. However, the rate of infections and mesh non-engraftment in animals with anti-adhesive gel were higher.