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KMID : 0350519930460020615
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Journal of Catholic Medical College
1993 Volume.46 No. 2 p.615 ~ p.634
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The Effects of Splint and Intraperitoneal Adjuvants on the Results after Reanastomosis of Rabbit Fallopian Tube
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Abstract
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The maintenance of tubal patency and the prevention of pelvic adhesion are the major keys for the successful fallopian tube surgery for infertility. Various kinds of tubal splints have been used to maintain tubal patency in clinical and
experimental
tuboplasties, but there are still undetermined factors such as the optimun duration of splint indwelling and its effects on tubal healing and patency.
Therefore, authors performed experimental tuboplasty in rabbits and attempted to know the effects of the nylon splint on tubal patency according to the duration of indwelling and also the effects of the intraperioneal adjuvants on pelvic
adhesion.
All
results were analyzed clinically and pathologically by using the light and electron microscopes.
The total number or experimental rabbits were 72. Both normal oviducts were obtained from three rabbits as a control group. In sixty nine rabbits experimental reananstomosis were performed at the ampullae of both oviduots and a nylon splint was
inserted
into only one oviduct of each rabbit. Twenty (Group I) of sixty nine rabbits were sacrificed on the lst week (seven), 2nd week (six) and 4th week (seven rabbits). In the remained forty nine rabbits (GroupⅡ), only the splint was removed on the
lst
week
(sixteen), 2dn week (seventeen) and 4th week (sixteen rabbits).
And finally, all of these GroupⅡ rabbits were sacrificed on the 8th week to obtain oviducts. To evaluate the preventive effect of intraperitoneal adjuvant against adhesion, twenty milliniters of saline, 10% dextran (Reomacrodex(r)), or combined
regimen
( saline, solumedrol, ampicillin and heparin) was applied into the pervic cavity of Group Ⅱ animals.
@ES The results were as follows :
@EN 1. The restoration of tubal peristalsis in Group Ⅱ was significantly high (75%) in one week splinted group as compared with other splinted groups (P<0.10), but thre was no significant difference compared with unsplinted groups.
2. The incidence of tubal patency in GroupⅡwas significantly high (81%) in one week splinted group as compared with other groups (P<0.10).
3. Inflammatory cell infiltration was increased along the duration of splint indwelling in GroupⅠbut only slight infiltration was noted in GroupⅡ without relation to the duration of splinting. Fibrosis was increased at the two and four weeks
splinted
groups compared with the one week splinted group of Groups Ⅰ&Ⅱ.
4. On scanning electron microscopic examination, the tissues adjacent to the anastomotic site were restored at two weeks after operation and the appearance of transformed ciliated and secretory cells was more frequent at the two and four weeks
splinted
groups than the one week splinted group of Groups Ⅰ & Ⅱ.
Transmission eletron microscopic examination for secretory cells of GroupⅠ showed decrease of microvilli and inrease of secrtory granules in one week splinted group but decreased number of both microvilli and granules in two weeks splinted
group.
5. On scanning electron microscopic field (×2000), the ratio of transformed to normal secretory cells was significantly lower in the one week splinted group than in the four weeks splinted group of GroupⅠ, and also lower in the unsplinted and
one
week splited groups than in the two and four weeks splinted groups of Group Ⅱ (P<0.05).
6. The incidence of pelvic adhesion was significantly lower in the canses in which combined regimen was used than in the cases in which saline or 10% dextran was used a an intraperitoneal adjuvant (P<0.05).
From the above results, it is considered that the retaining of tubal splint for one week and the use of combineed regimen as an intraperitoneal adjuvant may improve the results of tubal reanastomosis.
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KEYWORD
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