THE EFFECT OF DIAPHRAGMATIC PERITONEAL LYMPHATICS ON PERITONEAL ADHESIONS: AN EXPERIMENTAL STUDY

Abstract

In this study, we examined the effect of diaphragmatic peritoneal lymphatic function on theformation of peritoneal adhesions. A two phased design was used in fifty-two Wistar albinofemale rats. In the first phase (n=12), the effects of diaphragmatic peritoneum damage model onthe cecum and the terminal ileum were evaluated. In the second phase, the rats (n=40) weredivided into two equal groups. The adhesion model was created only in the cecum and theterminal ileum in the first group, whereas the diaphragmatic peritoneal damage model wascreated in the second group together with the same adhesion model. The rats were sacrificed onday 10 postoperatively and the adhesions formed were graded. In the first group, adhesions wereformed at grade 1 in 5 rats (25%), grade 2 in 11 rats (55%) and grade 3 in 4 rats (20%),whereas adhesions were formed at grade 1 in 2 rats (10%), grade 2 in 8 rats (40%) and grade 3in 10 rats (50%) in the second group (P²: 21.65, p<0.0001). Diaphragmatic peritoneallymphatic function reduced the number of adhesions and severity of the adhesions whichoccurred among intraabdominal organs after laparotomy. These findings suggest that specialcare should be undertaken to avoid damaging the diaphragmatic peritoneum during abdominalsurgery so as to reduce the incidence of peritoneal adhesions