| PrefacePeritoneum subjected to trauma responds with an natural plero-sis,and leads to peritoneal adhesions. Once peritoneal adhesive formation , it will cause abdominal discomfort and abdominalgia or even adhesive ileus and infertility . Some data show that about 85% ileus is caused by peritoneal adhesions and adhesiolysis , the recurrence rate is up to 90% ~ 100% . Therefore, how to prevent severe adhesion is a key to reduce postoperative complication. The investigation of adhesive mechanism and drug treatment has been studying for many years. We can sure that the reason of leading to peritoneal adhesion is trauma. Trauma causes inflammatory reaction and proliferation of fibroblast leads to fibrous bands formation. Octreotide ( Sandostatin ) , a long -acting somatostatin analogue that can inhibit local synthesis of insulin - like growth factor - I (IGF - I ) from inflammatory reaction and inhibit the responsiveness of T lymphocytes, and thus restraining the glycosaminoglycan ( GAG) synthesis in flbroblast. Further, it can step - up the recovery of postoperative gastric empty and intestinal ver-miculation. thereby, shortening the time of postoperative paralytic of intestine. The objective of this experiment is to observe whether oct-reotide has the effect on preventing peritoneal adhesions in rats.Material and MethodsSixty Wistar rats were used. In a same standard, peritoneal adhesions models were made by scraping the cecul serosal with a scalpel blade, then dropping absolute alcohol on the surface of the wound and clamping the parietal peritoneum against the wound with a hemostat. The rats were randomly divided into six groups with group one as control group . After the first laparotomy, the rats in group 1?2 and group 3 received postoperative days 0 through 14 normal saline 0. 5ml/12h as placebo or octreotide 0. 5ml 2. 5|xg/kg/12h or hydrocortisone 0. 5ml 2mg/kg/12h subcutanously respectively for two weeks. Rats in group a? b and group c received no interventions in the first two weeks. And on the 14th day after operation, Group a?b and c were performed adhesiolysis of peritoneal adhesions, After the adhesiolysis of peritoneal adhesions, three groups were given placebo or octreotide or hydrocortisone respectively for 14 days as rats in group 1?2 and 3. After the first laparotomy two weeks or four weeks, The severity of adhesion formation of six groups were graded respectively.ResultsCompared with control groups, octreotide reduces the adhesion not only after the first operation but also after the adhesiolysis of peritoneal adhesion ( p <0. 01) . However, hydrocortisone reduces the adhesion only in the first laparotomy, the effect is similar to the octreotide's. There is no significant discrepancy among the three groups in incisions healing ( p >0.05) .DiscussionThe mechanism of peritoneal adhesion formation has been recognized at some degree. In brief, it is a series of inflammatory reactions which lead to fibrous protein effusion and deposition . But the adhesiol-ysis ability of peritoneum to the fibrous protein has reduced and result in peritoneal adhesion formation. Additionally, tissue ischemia also advances the formation of peritoneal adhesion. For these reasons, to prevent peritoneal adhesion,the follow aspects must be regarded firstly : (1) to reduce the inflammatory reaction of trauma and prevent tissue ischemia; (2) to decrease the effusion of fibrous protein and advance its absorption; ( 3 ) to step - up the recovery of gastric and intestinal vermiculation prevent earlier postoperative paralysis of intestine.Peritoneal adhesion is caused by peritoneal trauma, simply improving the surgical technology can only reduce the development of adhesion but cant completely avoid the occurrence of adhesion. So it is necessary that using drugs to prevent peritoneal adhesion. Aim directly at those aspects, we use octreotide to prevent postoperative peritoneal adhesion. Octreotide is a synthetic octapeptide derivative of naturally occurring somatostatin. Octreotide can inhibit the direct...
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