Methylene blue reduces peritoneal adhesions in Syrian golden hamsters that undergo hepatopancreatic surgical procedures

Cintia Yoko Morioka; Marcel Cerqueira Cesar Machado; Jose Pinhata Otoch; Seiji Saito; Joelmir Lucena Veiga da Silva; Akiharu Watanabe; Hideki Arai; Takashi Sakamoto; Keiichi Yamamoto; Luiz Francisco Poli de Figueiredo

doi:10.18535/ijsrm/v9i05.mp04

Abstract

Tissue ischemia, mechanical or thermal trauma, infection and foreign body reaction predispose to adhesion formation. Adhesion formation resembles an inflammatory process. Sometimes, they appear as a bridge to wound healing, however, in other times it may cause small bowel obstruction. Methylene blue is known to inhibit the generation of oxygen radicals. Therefore, it may be used as an antioxidant reducing adhesion formation. Hamsters are animals used in surgical experiments, including pancreatic and hepatic surgeries.

Objective. To study the effectiveness of using methylene blue in hamsters that undergo hepatectomy or pancreatectomy.

Methods. Syrian golden hamsters were divided in 6 groups: Partial pancreatectomy with splenectomy (PPS), PPS and MB (PPS-MB), Partial hepatectomy (PH), PH and MB (PH-MB), Sham operation (SO), and Sham operation and MB (SO-MB). MB was administered intraperitoneally before closing abdominal wall. Side effects were observed. Animals were sacrificed 10 days later and adhesions were quantified.

Results. Adhesions were present in all animals (100%) of PH group and 3 of 5 (60%) of PPS group. In PH-MB and SO groups, 1 of 5 hamsters (20%) in each group showed adhesions. No adhesions were found in PPS-MB and SO-MB treated groups. None of animals showed loss of weight.

Conclusion. This study suggests that methylene blue administration showed to be effective to prevent adhesion formation in hepatopancreatic surgical procedures.

Keywords

AnimalAdhesionMethylene BluePancreatectomyHepatectomySplenectomyPeritoneum

References

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diZerega GS, Campeau JD. (2001) Peritoneal repair and post-surgical adhesion formation. Hum Reprod Update 7 (6):547-555. https://doi.org/10.1093/humupd/7.6.547DOI ↗Google Scholar ↗
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Mahdy T, Mohamed G, Elhawary A. (2008) Effect of methylene blue on intra-abdominal adhesion formation in rats. Int J Surg 6(6):452-5. https://doi.org/10.1016/j.ijsu.2008.08.004DOI ↗Google Scholar ↗
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Orita H, Fukasawa M, Girgis W, diZerega GS. (1992) Inhibition of postsurgical adhesions in a standardized rabbit model: intraperitoneal treatment with tissue plasminogen activator. Int J Pancreatol. 136 (3): 172-177.Google Scholar ↗
Panahi F, Sadraie SH, Khoshmohabat H, Shahram E, Kaka G, Hosseinalipour M. (2012) Macroscopic and pathological assessment of methylene blue and normal saline on postoperative adhesion formation in a rat cecum model. Int J Surg 10(9):537-4. https://doi.org/10.1016/j.ijsu.2012.08.009DOI ↗Google Scholar ↗
Senthilkumar MP, Dreyer JS. (2006) Peritoneal adhesions: pathogenesis, assessment and effects. Trop Gastroenterol 27 (1):11-18.Google Scholar ↗
Treutner KH, Schumpelick V. (2000) Prevention of adhesions. Wish and reality. Chirurg 71 (5): 510-7. https://doi.org/10.1007/s00104005084DOI ↗Google Scholar ↗

[refR-1] diZerega GS. (1997) Biochemical events in peritoneal tissue repair. Int J Pancreatol (577):10-16.Google Scholar ↗

[refR-2] diZerega GS, Campeau JD. (2001) Peritoneal repair and post-surgical adhesion formation. Hum Reprod Update 7 (6):547-555. https://doi.org/10.1093/humupd/7.6.547DOI ↗Google Scholar ↗

[refR-3] Galili Y, Ben-Ayraham R, Rabau M, Klausner J, Kluger Y. (1998) Reduction of surgery-induced peritoneal adhesions by methylene blue. Int J Pancreatol 175 (1): 30-32. https://doi.org/10.1016/s0002-9610(97)00232-8DOI ↗Google Scholar ↗

[refR-4] Heydrick SJ, Reed KL, Cohen PA, Aarons CB, Gower AC, Becker JM, Stucchi AF. (2007) Intraperitoneal administration of methylene blue attenuates oxidative stress, increases peritoneal fibrinolysis and inhibits intraabdominal adhesion formation. J Surg Res 143(2):311-9. https://doi.org/10.1016/j.jss.2006.11.012DOI ↗Google Scholar ↗

[refR-5] Kluger Y, Weinbroum A, Ben Ayraham R, Galili Y, Klausner J, Rabau M. (2000) Reduction in formation of peritoneal adhesions by methylene blue in rats: a dose response study. Eur J Surg 166 (7):568-571. https://doi.org/10.1080/110241500750008655DOI ↗Google Scholar ↗

[refR-6] Liakakos T, Thomakos N, Fine PM, Dervnis C, Young RL. (2001) Peritoneal adhesions: etiology, pathophysiology, and clinical significance. Recent advances in prevention and management. Dig Surg 18 (4): 260-273. https://doi.org/10.1159/000050149DOI ↗Google Scholar ↗

[refR-7] Mahdy T, Mohamed G, Elhawary A. (2008) Effect of methylene blue on intra-abdominal adhesion formation in rats. Int J Surg 6(6):452-5. https://doi.org/10.1016/j.ijsu.2008.08.004DOI ↗Google Scholar ↗

[refR-8] Morioka CY, Saito S, Kita K, Watanabe,A. (2000) Curative resection of orthotopically implanted pancreatic cancer in Syrian golden hamsters. Int J Pancreatol 28 (3): 207-213. https://doi.org/10.1385/ijgc:28:3:207DOI ↗Google Scholar ↗

[refR-9] Orita H, Fukasawa M, Girgis W, diZerega GS. (1992) Inhibition of postsurgical adhesions in a standardized rabbit model: intraperitoneal treatment with tissue plasminogen activator. Int J Pancreatol. 136 (3): 172-177.Google Scholar ↗

[refR-10] Panahi F, Sadraie SH, Khoshmohabat H, Shahram E, Kaka G, Hosseinalipour M. (2012) Macroscopic and pathological assessment of methylene blue and normal saline on postoperative adhesion formation in a rat cecum model. Int J Surg 10(9):537-4. https://doi.org/10.1016/j.ijsu.2012.08.009DOI ↗Google Scholar ↗

[refR-11] Senthilkumar MP, Dreyer JS. (2006) Peritoneal adhesions: pathogenesis, assessment and effects. Trop Gastroenterol 27 (1):11-18.Google Scholar ↗

[refR-12] Treutner KH, Schumpelick V. (2000) Prevention of adhesions. Wish and reality. Chirurg 71 (5): 510-7. https://doi.org/10.1007/s00104005084DOI ↗Google Scholar ↗