Postoperative adhesion prevention with low-dose aspirin: effect through the selective inhibition of thromboxane production |
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Authors: | Muzii L; Marana R; Brunetti L; Margutti F; Vacca M; Mancuso S |
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Institution: | Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, Rome, Italy. |
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Abstract: | The aim of the present study was to evaluate the efficacy of low-dose
versus high-dose aspirin in the prevention of postoperative adhesion
formation. Forty New Zealand White rabbits were randomized into three
groups: low-dose aspirin (1.7 mg/kg per day for 5 days starting on the day
of surgery), high-dose aspirin (28.0 mg/kg per day), and controls. The
rabbits underwent a standardized surgical injury on the ovary, uterine horn
and abdominal wall on one side at laparotomy. On postoperative day 21, a
second-look laparotomy was performed for the evaluation of postoperative
adhesions. In five animals in each group, peritoneal fluid samples were
collected at initial surgery, then through an additional 2 cm incision
performed on postoperative day 3, and at second-look laparotomy. The
peritoneal concentrations of thromboxane B2 and 6-keto-prostaglandin
F1alpha (the stable hydrolysis product of prostacyclin) were measured by
radioimmunoassay. At second- look laparotomy, the adhesion formation rate
was 46% in the low-dose aspirin group, 77% in the high-dose group, and 100%
in the control group. The adhesion score in the low-dose group was
significantly lower (P < 0.01) than in the high-dose and control groups.
Peritoneal thromboxane decreased significantly during treatment in both
low-dose and high-dose aspirin groups, whereas prostacyclin decreased only
in the high-dose group. Postoperative adhesion reduction observed in this
study with low-dose aspirin treatment could be due to the selective
inhibition of thromboxane over prostacyclin production.
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