Songül ÇERİBAŞI, Ömer Faruk GÜNDÜZ, Mehmet Cengiz HAN, Ali Said DURMUŞ, Aydın SAĞLIYAN

Metilprednizolon ve Meloksikamın İntraabdominal Adezyonların Önlenmesi Üzerine Etkileri

Bu çalışmanın amacı, non steroid anti inflamatuar (NSAİİ) bir ilaç olan meloksikam ile steroid birajan olan metilprednizolonun ratlarda intraabdominal adezyonların önlenmesi üzerine olan etkilerinikarşılaştırmaktı. Çalışmada 21 adet 2-3 aylık dişi Wistar albino rat kullanıldı. Ratlar her grupta 7adet olacak şekilde 3 gruba ayrıldı. İki cm’lik laparatomi sonrasında karın duvarı ve sekumunvisseral yüzeyinde serosal kanama oluşana kadar kazıma işlemi yapılarak bir yapışma modelioluşturuldu. Operasyon yaraları rutin cerrahi kurallara göre kapatıldı. Birinci, ikinci ve üçüncügruptaki ratlara 5 gün süreyle intraperitoneal olarak sırasıyla 7 mL/kg serum fizyolojik (kontrol), 5mg/kg meloksikam ve 10 mg/kg metilprednizolon verildi. Ratlar ondört gün sonra ötenazi edildiktensonra oluşan adezyonlar değerlendirildi. Makroskopik değerlendirmede tedavi gruplarında adezyonoluşumu kontrol grubuna göre daha az olarak gözlendi (P=0.016). Yapılan histopatolojikkontrollerde, yangı şiddeti kontrol grubunda daha belirgindi. Fibrozis en belirgin olarak kontrolgrubunda gözlendi (P=0.016). İmmunohistokimyasal değerlendirmelerde IL-1 pozitif hücre sayısınınkontrol grubunda tedavi gruplarına göre daha fazla olduğu belirlendi (P=0.016). Sonuç olarakintraabdominal adezyonların önlenmesinde meloksikam ve metilprednizolonun kullanılabileceğikanısına varılmıştır.

Effects of Methylprednisolone and Meloxicam on the Prevention of Intraabdominal Adhesions

The aim of this study was to compare the effects of meloxicam, a non steroidal anti inflammatory (NSAID) drug, and methylprednisolone, a steroid agent, on the prevention of intraabdominal adhesions in rats. Twenty-one 2-3 months old female Wistar albino rats were used in the study. The rats were divided into 3 groups as 7 rats in each group. After 2 cm laparotomy, an adhesion model was formed by performing scraping process on the visceral surface of the abdominal wall and caecum until serosal hemorrhage occurred. Operation wounds were closed according to routine surgical rules. Seven mL/kg saline (control), 5 mg/kg meloxicam and 10 mg/kg methylprednisolone were given intraperitoneally to the rats in the first, second and third groups for 5 days respectively. After 14 days, rats received general anesthesia and occured adhesions were graded. Fourteen days later, the rats euthanized and were evaluated for the presence of adehesions. In the macroscopic evaluation, adhesion formation in treatment groups was less than in the control group (P=0.016). In the histopathological examination, the severity of the inflammation was more marked in the control group. Fibrosis was most significantly observed in the control group (P=0.016). Immunohistochemical evaluation revealed that IL-1 positive cell number was higher in the control group than in the treatment groups (P=0.016). As a result, it was concluded that meloxicam and methylprednisolone could be used in the prevention of intraabdominal adhesions.

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