Chemical Scalpel: An Experimental Collagenase-Based Treatment for Peritoneal Adhesions

化学手术刀:基于胶原酶的腹膜粘连实验治疗

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作者:Javier Barambio, Mariano García-Arranz, Pedro Villarejo Campos, Juan Felipe Vélez Pinto, Luz Vega Clemente, Soledad García Gómez-Heras, Héctor Guadalajara, Damián García-Olmo

Background

Abdominal adhesions are a common disease appearing after any type of abdominal surgery and may prolong surgical time and cause intestinal obstruction, infertility, or chronic pain. We propose the use of intraperitoneal collagenase to perform chemical adhesiolysis based on the pathophysiology and histology of adhesions. (2)

Conclusions

Collagenase allows for the safe and effective chemical adhesiolysis in this experimental model of adhesions.

Methods

We generated an adhesion model with intraperitoneal polypropylene meshes. Four months later, we evaluated the efficacy of the treatment in blinded form, i.e., 0.05% collagenase vs. placebo at 37 °C for 20 min. Protocol 1: Ten rats with ten mesh fragments, in which an attempt was made to remove the maximum number of meshes in a 5-min period. Protocol 2: Six rats with four mesh fragments in the sides of the abdominal cavity in which adhesiolysis was performed using a device that measures burst pressure. (3)

Results

Protocol 1: 42% efficacy in the collagenase group versus 8% in the control group (p < 0.013). Protocol 2: 188.25 mmHg (SD 69.65) in the collagenase group vs. 325.76 mmHg (SD 50.25) in the control group (p < 0.001). (4) Conclusions: Collagenase allows for the safe and effective chemical adhesiolysis in this experimental model of adhesions.

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