Peritoneal Response to Abdominal Surgery: the Role of Equine Abdominal Adhesions and Current Prophylactic Strategies

Overview

Journal Vet Med Int

Publisher Wiley

Specialty Veterinary Medicine

Date 2014 Mar 4

PMID 24587939

Citations 7

Authors

Juliana de Moura Alonso

Ana Liz Garcia Alves

Marcos Jun Watanabe

Celso Antonio Rodrigues

Carlos Alberto Hussni

Affiliations

Soon will be listed here.

Abstract

Intra-abdominal adhesions constitute a significant clinical and surgical problem that can lead to complications such as pain and bowel occlusion or subocclusion. These adhesions are frustrating and potentially fatal, representing a major postoperative complication in abdominal surgery. It is estimated that 32% of horses undergoing laparotomy will present clinical symptoms due to adhesions, but the true prevalence is not known because a large proportion of animals with postoperative recurrent colics are medically treated or submitted to euthanasia without necropsy. Adhesions are highly cellular, vascularized, dynamic structures that are influenced by complex signaling mechanisms. Understanding their pathogenesis could assist in applying better therapeutic strategies and in developing more effective antiadhesion products. Currently, there are no definitive strategies that prevent adhesion formation, and it is difficult to interpret the results of existing studies due to nonstandardization of an induction model and evaluation of their severity. The best clinical results have been obtained from using minimally traumatic surgical techniques, anti-inflammatory agents, antimicrobials, anticoagulants, and mechanical separation of serosal surfaces by viscous intraperitoneal solutions or physical barriers. This paper aims to review adhesion formation pathogenesis, guide the understanding of major products and drugs used to inhibit adhesion formation, and address their effectiveness in the equine species.

Citing Articles

Partial volvulus, entrapment, and extraluminal obstruction of the jejunum in a cat.

Hadala A, Lavallee J Can Vet J. 2023; 64(8):742-746.

PMID: 37529392 PMC: 10352039.

Indomethacin Sustained-Release Anti-adhesion Membrane Composed of a Phospholipid and Polycaprolactone Blend.

Efatpanah A, Rabbani S, Talimi R, Mortazavi S, Haeri A Iran J Pharm Res. 2023; 21(1):e127353.

PMID: 36710990 PMC: 9872549. DOI: 10.5812/ijpr-127353.

Vitamin E administration as preventive measures for peritoneal/intra-abdominal adhesions: A systematic review and meta-analysis.

Sudirman T, Hatta M, Prihantono P, Bukhari A, Tedjasaputra T, Lie H Ann Med Surg (Lond). 2022; 80:104225.

PMID: 36045847 PMC: 9422189. DOI: 10.1016/j.amsu.2022.104225.

An apparently healthy female crossbred Labrador retriever-poodle dog with severe intra-abdominal adhesions as an incidental finding to ovariohysterectomy.

Brown C Can Vet J. 2022; 63(2):194-196.

PMID: 35110778 PMC: 8759341.

Ex Vivo Comparison of a UV-Polymerizable Methacrylate Adhesive versus an Inverting Pattern as the Second Layer of a Two-Layer Hand-Sewn Jejunal Anastomosis in Horses: A Pilot Study.

Lenoir A, Perrin B, Lepage O Vet Med Int. 2021; 2021:5545758.

PMID: 33884160 PMC: 8041519. DOI: 10.1155/2021/5545758.

References

Morello S, Southwood L, Engiles J, Slack J, Crack A, Springate C . Effect of intraperitoneal PERIDAN™ concentrate adhesion reduction device on clinical findings, infection, and tissue healing in an adult horse jejunojejunostomy model. Vet Surg. 2012; 41(5):568-81. DOI: 10.1111/j.1532-950X.2012.00951.x. View

Parker J, Fibini S, Car B, Erb H . Prevention of intraabdominal adhesions in ponies by low-dose heparin therapy. Vet Surg. 1987; 16(6):459-62. DOI: 10.1111/j.1532-950x.1987.tb00988.x. View

Weibel M, Majno G . Peritoneal adhesions and their relation to abdominal surgery. A postmortem study. Am J Surg. 1973; 126(3):345-53. DOI: 10.1016/s0002-9610(73)80123-0. View

Freeman D, Hammock P, Baker G, Goetz T, Foreman J, Schaeffer D . Short- and long-term survival and prevalence of postoperative ileus after small intestinal surgery in the horse. Equine Vet J Suppl. 2001; (32):42-51. DOI: 10.1111/j.2042-3306.2000.tb05333.x. View

Schnuriger B, Barmparas G, Branco B, Lustenberger T, Inaba K, Demetriades D . Prevention of postoperative peritoneal adhesions: a review of the literature. Am J Surg. 2010; 201(1):111-21. DOI: 10.1016/j.amjsurg.2010.02.008. View

Altuntas Y, Kement M, Oncel M, Sahip Y, Kaptanoglu L . The effectiveness of hyaluronan-carboxymethylcellulose membrane in different severity of adhesions observed at the time of relaparotomies: an experimental study on mice. Dis Colon Rectum. 2008; 51(10):1562-5. DOI: 10.1007/s10350-008-9385-2. View

Arung W, Jehaes F, Cheramy J, Defraigne J, Meurisse M, Honore P . Effects of parecoxib on the prevention of postoperative peritoneal adhesions in rats. J Invest Surg. 2013; 26(6):340-6. DOI: 10.3109/08941939.2013.810316. View

Delgado M, Monreal L, Armengou L, Rios J, Segura D . Peritoneal D-dimer concentration for assessing peritoneal fibrinolytic activity in horses with colic. J Vet Intern Med. 2009; 23(4):882-9. DOI: 10.1111/j.1939-1676.2009.0344.x. View

Gutt C, Oniu T, Schemmer P, Mehrabi A, Buchler M . Fewer adhesions induced by laparoscopic surgery?. Surg Endosc. 2004; 18(6):898-906. DOI: 10.1007/s00464-003-9233-3. View

10.

Chaturvedi A, Lomme R, Hendriks T, van Goor H . Prevention of postsurgical adhesions using an ultrapure alginate-based gel. Br J Surg. 2013; 100(7):904-10. DOI: 10.1002/bjs.9131. View

11.

Maciver A, McCall M, Shapiro A . Intra-abdominal adhesions: cellular mechanisms and strategies for prevention. Int J Surg. 2011; 9(8):589-94. DOI: 10.1016/j.ijsu.2011.08.008. View

12.

Moore B, Hinchcliff K . Heparin: a review of its pharmacology and therapeutic use in horses. J Vet Intern Med. 1994; 8(1):26-35. DOI: 10.1111/j.1939-1676.1994.tb03192.x. View

13.

Menzies D, Ellis H . Intestinal obstruction from adhesions--how big is the problem?. Ann R Coll Surg Engl. 1990; 72(1):60-3. PMC: 2499092. View

14.

Gorvy D, Barrie Edwards G, Proudman C . Intra-abdominal adhesions in horses: a retrospective evaluation of repeat laparotomy in 99 horses with acute gastrointestinal disease. Vet J. 2007; 175(2):194-201. DOI: 10.1016/j.tvjl.2007.02.016. View

15.

Fogle C, Gerard M, Elce Y, Little D, Morton A, Correa M . Analysis of sodium carboxymethylcellulose administration and related factors associated with postoperative colic and survival in horses with small intestinal disease. Vet Surg. 2009; 37(6):558-63. DOI: 10.1111/j.1532-950X.2008.00420.x. View

16.

Cheong Y, Premkumar G, Metwally M, Peacock J, Li T . To close or not to close? A systematic review and a meta-analysis of peritoneal non-closure and adhesion formation after caesarean section. Eur J Obstet Gynecol Reprod Biol. 2009; 147(1):3-8. DOI: 10.1016/j.ejogrb.2009.06.003. View

17.

van den Boom R, van der Velden M . Short-and long-term evaluation of surgical treatment of strangulating obstructions of the small intestine in horses: a review of 224 cases. Vet Q. 2001; 23(3):109-15. DOI: 10.1080/01652176.2001.9695095. View

18.

Gao X, Deng X, Wei X, Shi H, Wang F, Ye T . Novel thermosensitive hydrogel for preventing formation of abdominal adhesions. Int J Nanomedicine. 2013; 8:2453-63. PMC: 3716558. DOI: 10.2147/IJN.S46357. View

19.

Chu D, Lim R, Heydrick S, Gainsbury M, Abdou R, DAddese L . N-acetyl-l-cysteine decreases intra-abdominal adhesion formation through the upregulation of peritoneal fibrinolytic activity and antioxidant defenses. Surgery. 2011; 149(6):801-12. DOI: 10.1016/j.surg.2011.02.015. View

20.

Johns A . Evidence-based prevention of post-operative adhesions. Hum Reprod Update. 2001; 7(6):577-9. DOI: 10.1093/humupd/7.6.577. View