Adhesion formation from release of dermoid contents in the peritoneal cavity and effect of copious lavage: a prospective, randomized, blinded, controlled study in a rabbit model

• Published in: Fertility and sterility Vol. 65; no. 4; pp. 852 - 859
• Main Authors: Fiedler, Eric P., Guzick, David S., Guido, Richard, Kanbour-Shakir, Amal, Krasnow, Joel S.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.1996; Elsevier Science
• Subjects: adhesions; animal model; Animals; Biological and medical sciences; dermoid; Dermoid Cyst - complications; Dermoid Cyst - surgery; Disease Models, Animal; Female; Humans; lavage; Medical sciences; Ovarian Neoplasms - complications; Ovarian Neoplasms - surgery; Peritoneal Diseases - etiology; Peritoneal Diseases - prevention & control; Peritoneal Lavage; Peritonitis; Peritonitis - etiology; Peritonitis - prevention & control; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Rabbits; Rupture; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; teratoma; Tissue Adhesions - etiology; Tissue Adhesions - prevention & control; dermoid; teratoma; animal model; adhesions; Peritonitis; lavage; Performance evaluation; Dermoid cyst; Peritoneal adhesion; Rupture; Rabbit; Surgical resection; Washing; Lagomorpha; Female genital diseases; Ovarian diseases; Ovary; Vertebrata; Experimental disease; Mammalia; Abdominal disease; Surgery; Animal; Cyst; Complication; Benign neoplasm; Peritoneum
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/S0015-0282(16)58225-9

To determine, in a rabbit model, whether peritoneal exposure to dermoid cyst material produces inflammation and adhesions above control levels and whether saline lavage reduces the degree of peritoneal reaction. A prospective, randomized, blinded, controlled study of adhesion formation. Thirty New Zealand white female rabbits were assigned randomly to five experimental groups: [1] laparoscopy with intraperitoneal injection of human dermoid material, [2] laparoscopy with intraperitoneal injection of human dermoid material and subsequent lavage to clear all visible dermoid material, [3] laparoscopy with saline lavage, [4] laparoscopy with intraperitoneal injection of human follicular fluid (antigenic control), and [5] laparoscopy alone. Six weeks after initial laparoscopy, inflammation and adhesions were scored in several categories via visual assessment (range 0 to 15) and histologic microscopic evaluation (range 0 to 24). Data were evaluated using Kruskal-Wallis and Mann-Whitney U nonparametric tests. For groups 1, 2, 3, 4, and 5, respectively, mean ± SEM total inflammation-adhesion scores were 13.85 ± 0.55, 2.90 ± 1.15, 0 ± 0, 1.50 ± 1.00, and 0 ± 0 for clinical evaluation and 16.83 ± 1.22, 7.33 ± 1.76, 0 ± 0,0 ± 0, and 0 ± 0 for histologic evaluation. Using nonparametric tests, significant differences were found between groups in clinical and histologic scores. Dermoid material produces a significant peritonitis. Results of the clinical evaluation demonstrate that saline lavage brings inflammation and adhesion formation close to control levels. However, results of the histologic evaluation suggest that the decrement in inflammation as a result of lavage may be less dramatic than that found by clinical evaluation.