Yonsei Med J.  2007 Aug;48(4):659-664. 10.3349/ymj.2007.48.4.659.

The Effects of Melatonin on Postoperative Intraabdominal Adhesion Formation

Affiliations
  • 1Department of General Surgery, Trakya University, Medical Faculty, Edirne, Turkey. turkyilmazz@yahoo.com
  • 2Department of Physiology, Trakya University, Medical Faculty, Edirne, Turkey.

Abstract

PURPOSE
Postoperative intraabdominal adhesion formation is a major clinical problem. No previous study was found, reporting the relationship between adhesion formation and melatonin administration, but melatonin, a strong antioxidant, is recognized to have certain effects on the progression of adhesion formation mechanism. It was therefore decided to investigate the effects of melatonin on postoperative adhesion formation. MATERIALS AMD METHODS: A total number of 24 Spraque-Dawley rats were utilized. Three groups, described as: Group A, sham laparatomy (n=8), Group B, rats that underwent only ischemia-reperfusion (n=8) and Group C, rats that underwent ischemia- reperfusion and were given 10 mg/kg melatonin solution i.v. (n=8). For Groups B and C, the ileocolic vessels were clamped. Blood glutathione peroxidase levels of all study groups were assessed, then microscopic and macroscopic adhesion scores were evaluated. RESULTS: Glutathione peroxidase levels of the melatonin-treated group were significantly higher and fibroblast proliferation and macroscopic adhesion scores were significantly lower, than in the melatonin-free group. CONCLUSION: The results of this study supported the hypothesis, that melatonin administration may prevent intraabdominal adhesions resulting from surgery.

Keyword

Intraabdominal adhesion; melatonin; ischemia-reperfusion injury

MeSH Terms

Abdomen/pathology/*surgery
Animals
Antioxidants/*therapeutic use
Melatonin/*therapeutic use
Postoperative Complications/*prevention & control
Rats
Rats, Sprague-Dawley
Tissue Adhesions/drug therapy/pathology

Figure

  • Fig. 1 Current hypothesis of adhesion formation (from Holmdahl et al.6).

  • Fig. 2 An area of the fibrous band and/or peritoneum. H & E stain (original magnification 100 ×). (A) Microscopic view of a subject from the ischemia-reperfusion group. (B) Microscopic view of a subject in which ischemia-reperfusion was established after melatonin administration. Significant fibroblast proliferation was observed in A compared to B.


Reference

1. DeCherney AH, diZerega GS. Clinical problem of intraabdominal postsurgical adhesion formation following general surgery and use of adhesion prevention barriers. Surg Clin North Am. 1997. 77:671–688.
Article
2. Bigatti G, Boeckx W, Gruft L, Segers N, Brosens I. Experimental model for neoangiogenesis in adhesion formation. Hum Reprod. 1995. 10:2290–2294.
3. Menzies D. Postoperative adhesions: Their treatment and relevance in clinical practice. Ann R Coll Surg Engl. 1993. 75:147–153.
4. Ellis H. The cause and prevention of intestinal adhesions. Br J Surg. 1982. 69:241–243.
5. Wurster SH, Bonet V, Mayberry A, Hoddinott M, Williams T, Chaudry I. Intraperitoneal sodium carboxymethylcellulose administration prevents reformation of peritoneal adhesions following surgical lysis. J Surg Res. 1995. 59:97–102.
Article
6. Holmdahl LE, Al-Jabreen M, Risberg B. Role of fibrinolysis in the formation postoperative adhesions. Wound Rep Regen. 1992. 4:171–176.
7. Carrossino AM, Lombardi A, Matucci-Cerinic M, Pignone A, Cagnoni M. Effect of melatonin on normal and sclerodermic skin fibroblast proliferation. Clin Exp Rheumatol. 1996. 14:493–498.
8. Leach C, Thorburn GA. Comparision of the inhibitory effectsof melatonin and indomethacin on plateletaggregation and thromboxane release. Prostaglandins. 1980. 20:51–56.
Article
9. Gimeno MF, Landa A, Sterin-Speziale NS, Cardinali DP, Gimeno AL. Melatonin bloks in vitrogeration of prostaglandins by the uterus and hypotalamus. Eur J Pharmacol. 1980. 62:309–317.
Article
10. Gimeno MF, Ritta MN, Bonacossa A, Lazzari M, Gimeno AL, Cardinali DP. Birau , editor. Inhibition by melatonin of prostaglandin synthesis in hypotalamus, uterus and platelets. Melatonin: Current Status and Perspective. 1980. Pergamon Press;147–150.
Article
11. Reiter RJ. Functional pleiotropy of the neurohormone melatonin: antioxidant protection and neuroendocrine regulation. Front Neuroendocrinol. 1995. 16:383–415.
Article
12. Reiter RJ, Carneiro RC, Oh CS. Melatonin in relation to cellular antioxidative defense mechanisms. Horm Metab Res. 1997. 29:363–372.
Article
13. Reiter RJ, Guerrero JM, Garcia JJ, Acuna Castroviejo D. Reactive oxygen intermediates, moleculer damage, and aging: relation to melatonin. Ann N Y Acad Sci. 1998. 854:410–424.
Article
14. Baykal A, Özdemir A, Renda N, Korkmaz A, Sayek I. The effect of octreotide on postoperative adhesion formation. Can J Surg. 2000. 43:43–47.
15. Cabeza J, Motilva V, Martin MJ, de la Lastra CA. Mechanisms involved in gastric protection of melatonin againts oxidant strees by ischemia-reperfusion in rats. Life Sci. 2001. 68:1405–1415.
Article
16. Oelsner G, Graebe RA, Pan SB, Haseltine FP, Barnea ER, Fakih H, et al. Chondroitin sulfate: a new intraperitoneal treatment for postoperative adhesion prevention in the rabbit. J Reprod Med. 1987. 32:812–814.
17. Holtz G. Prevention and management of peritoneal adhesions. Fertil Steril. 1984. 41:472–504.
18. Kaleli B, Özden A, Aybek Z, Bostancı B. The effect of L-arginin and pentoxyfilline on postoperative adhesion. Acta Obstet Gynecol Scand. 1998. 77:377–380.
Article
19. Çubukçu A, Alponat A, Gönüllü NN, Özkan S, Erçin C. An experimental study evaluating the effect of mitomycin C on the prevention of postoperative intraabdominal adhesions. J Surg Res. 2001. 96:163–166.
Article
20. Tan DX, Chen LD, Poeggeler B, Manchester LC, Reiter RJ. Melatonin: a potent, endogenous hydroxyl radical scavenger. Endocr J. 1993. 1:57–60.
21. Sewerynek E, Reiter RJ, Melchiorri D, Ortiz GG, Lewinski A. Oxidative damage in the liver induced by ischemia-reperfusion: protection by melatonin. Hepatogastroenterology. 1996. 43:898–905.
22. Beyer CE, Steketee JD, Saphier D. Antioxidant properties of melatonin- an emerging mystery. Biochem Pharmacol. 1998. 56:1265–1272.
23. De La Lastra CA, Cabeza J, Motilva V, Martin MJ. Melatonin protect againts gastric ischemia-reperfusion injury in rats. J Pineal Res. 1997. 23:47–52.
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