Primer kalp cerrahisi ameliyatlarından sonra gelişen retrosternal perikardiyal yapışıklıkların Mitomisin C ile önlenmesi (Deneysel çalışma)
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Dosyalar
Tarih
2007
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Retrosternal perikardiyal adezyonlar reoperasyon gereken olgularda önemli oranda kalp ve büyük damar yaralanmalarına neden olabilir. Fibroblast proliferasyonu adezyon oluşum mekanizmalarından biridir. Fibroblast proliferasyonunun engellenmesi retrosternal adezyonların azaltılmasında önemlidir. Mitomisin C (MMC) fibroblast proliferasyonunu azaltmaktadır. Çalışmamızın amacı primer kalp cerrahisi ameliyatlarından sonra gelişen retrosternal perikardiyal yapışıklıkların önlenmesinde MMC'nin etkilerini belirlemekti.Gereç ve yöntem: Çalışmada 30 adet Sprague-Dawley cinsi dişi sıçan kullanıldı. Sıçanlar iki gruba ayrıldı. İlk grup kontrol (N=10) ve ikinci grup MMC çalışma grubu (N=20) olarak belirlendi. Her iki gruba subksifoid kesi yapılarak ksifoid kıkırdak rezeksiyonu ve retrosternal abrazyon yapıldı. Çalışma grubunda, retrosternal alana topikal olarak MMC (1 mg/kg) uygulandı. 15 gün sonra, reoperasyon yapıldı ve adezyon oluşumu evrelendi. Sakrifikasyon işlemi öncesinde doku ve kan örnekleri alındı. Doku örneklerine standart boyama işlemleri ve fibroblast growth faktör reseptör 3 antikor boyası immünhistokimyasal olarak uygulandı.Sonuçlar: Ortalama adezyon skoru kontrol grubunda (N=10) 2.50 ± 1.27 ve MMC çalışma grubunda 0.70 ± 0.86 olarak bulundu. Çalışma grubunda adezyon skoru kontrol grubuna göre daha düşüktü (p<0.05). MMC'ye ait herhangi bir yan etki gözlenmedi. İmmünhistokimyasal örnekler, çalışma grubuna göre kontrol grubunda fibroblast yoğunluğunun daha yüksek bulundu (p<0.05). Hidroksiprolin düzeyleri her iki grupta benzerdi (p>0.05).Sonuç: Bu çalışmada, MMC'nin normal yara iyileşmesinde herhangi bir gecikmeye neden olmaksızın retrosternal perikardiyal adezyonları önlediği ortaya konulmuştur.
Retrosternal pericardial adhesions may cause significant injuries to the heart and great vessels in cases that require reoperation. Fibroblast proliferation is one of the mechanisms for adhesion formation. Inhibition of fibroblast proliferation is important in the reduction of retrosternal adhesions. MMC is able to reduce fibroblast proliferation. We aimed to determine the effect of MMC on the prevention of retrosternal pericardial adhesions after primary cardiac operations.Material and methods: Thirty Sprague-Dawley female rats were used in the study. The rats were divided into two groups. First group was control (N=10), second group was MMC study group (N=20). All the groups were appiled xiphoid cartilage resection and retrosternal abrasion via subxiphoidal incision. In study group, MMC (1 mg/kg) was topically applied to the retrosternal space. After 15 days, reoperation was taken and formation of adhesions were graded. Tissue and blood samples were taken before sacrification procedure. Tissue samples were applied standart staining procedures and fibroblast growth factor receptor 3 antibody staining, immunohistochemically.Results: The average adhesion scores of the control (N=10) and study (N=20) (MMC; 1 mg/kg) groups were 2.50 ± 1.27 and 0.70 ± 0.86, respectively. Adhesion score of study group was lower than control group (p<0.05). No side effect of MMC was observed. Immunohistochemical samples were revealed that tissue fibroblast intensity was significantly higher in control group than study group (p<0.05). There was no statistically significance between two groups in case of hydroxyproline levels (p>0.05).Conclusion: In conclusion without any delay in normal tissue regeneration MMC was found to be effective in the prevention of retrosternal pericardial adhesions.
Retrosternal pericardial adhesions may cause significant injuries to the heart and great vessels in cases that require reoperation. Fibroblast proliferation is one of the mechanisms for adhesion formation. Inhibition of fibroblast proliferation is important in the reduction of retrosternal adhesions. MMC is able to reduce fibroblast proliferation. We aimed to determine the effect of MMC on the prevention of retrosternal pericardial adhesions after primary cardiac operations.Material and methods: Thirty Sprague-Dawley female rats were used in the study. The rats were divided into two groups. First group was control (N=10), second group was MMC study group (N=20). All the groups were appiled xiphoid cartilage resection and retrosternal abrasion via subxiphoidal incision. In study group, MMC (1 mg/kg) was topically applied to the retrosternal space. After 15 days, reoperation was taken and formation of adhesions were graded. Tissue and blood samples were taken before sacrification procedure. Tissue samples were applied standart staining procedures and fibroblast growth factor receptor 3 antibody staining, immunohistochemically.Results: The average adhesion scores of the control (N=10) and study (N=20) (MMC; 1 mg/kg) groups were 2.50 ± 1.27 and 0.70 ± 0.86, respectively. Adhesion score of study group was lower than control group (p<0.05). No side effect of MMC was observed. Immunohistochemical samples were revealed that tissue fibroblast intensity was significantly higher in control group than study group (p<0.05). There was no statistically significance between two groups in case of hydroxyproline levels (p>0.05).Conclusion: In conclusion without any delay in normal tissue regeneration MMC was found to be effective in the prevention of retrosternal pericardial adhesions.
Açıklama
Anahtar Kelimeler
Adezyonlar, Adhesions
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Orhan, A. (2007). Primer kalp cerrahisi ameliyatlarından sonra gelişen retrosternal perikardiyal yapışıklıkların Mitomisin C ile önlenmesi (Deneysel çalışma). (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Göğüs Cerrahisi Anabilim Dalı, Konya.
