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Crispi CP, Crispi CP, Mendes FLF, de Andrade CM, Cardeman L, de Nadai Filho N, Portari EA, Fonseca MDF. Practical considerations in the use of a porcine model (Sus scrofa domesticus) to assess prevention of postoperative peritubal adhesions. PLoS One 2020; 15:e0219105. [PMID: 31918436 PMCID: PMC6952254 DOI: 10.1371/journal.pone.0219105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 12/21/2019] [Indexed: 01/20/2023] Open
Abstract
Infertility has been a common postoperative problem caused by peritoneal adhesions. Since several prophylactic agents have recently shown promising preliminary results, more complete studies comparing their real efficacy and safety are needed urgently. The aim of this study was to investigate and describe practical considerations of a porcine model that can be used to assess such prophylactic agents. First, 10 healthy 5½ months old female pigs (24.3-31.3 Kg) underwent a standardized laparoscopy to provoke peritubal adhesion formation without prophylactic agents. After 30 days, a second-look laparoscopy was performed to evaluate adhesions and perform adnexectomy for histopathological evaluation. Adhesions at different sites were classified by grade, for which the scores range from 0 (no adhesion) to 3 (very strong vascularized adhesions), and also by area, with scores ranging from 0 (no adhesion) to 4 (>75% of the injured area). The histopathological evaluation of the distal uterine horns, oviducts and ovaries were compared withthose from a control group of six healthy pigs with no previous surgery. Biological samples were collected to assess vitality, inflammation and renal, hepatic and hematopoietic systems. There were small (but significant) changes in serum albumin (P = 0.07), globulin (P = 0.07), C-reactive protein (P = 0.011), fibrinogen (P = 0.023) and bilirubin (P<0.01) after 30 days, but all values were within the normal range. No inflammation or abscess formation was observed, but different degrees of adhesion were identified. The estimated occurrence of adhesion (scores >0) and of strong / very strong adhesion (scores >1) was 75% (95% CI: 55-94.9) and 65% (95% CI: 45-85), respectively. The porcine model represents a useful animal platform that can be used to test the efficacy and safety of candidate prophylactic agents intended to prevent postoperative peritubal adhesions formation. We present several practical considerations and measures that can help to minimize animal suffering and avoid problems during such experiments.
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Affiliation(s)
- Claudio Peixoto Crispi
- Surgical Training Center, SUPREMA University, Juiz de Fora, Minas Gerais, Brazil
- Crispi Institute of Minimally Invasive Surgery, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Claudio Peixoto Crispi
- Surgical Training Center, SUPREMA University, Juiz de Fora, Minas Gerais, Brazil
- Crispi Institute of Minimally Invasive Surgery, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernando Luis Fernandes Mendes
- Department of Surgery and Anesthesia, College of Veterinary Medicine, UNIFESO University, Teresópolis, Rio de Janeiro, Brazil
| | | | - Leon Cardeman
- Leon Cardeman Laboratory of Cytopathology, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Nilton de Nadai Filho
- Surgical Training Center, SUPREMA University, Juiz de Fora, Minas Gerais, Brazil
- Crispi Institute of Minimally Invasive Surgery, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Elyzabeth Avvad Portari
- Department of Women’s Health, Fernandes Figueira National Institute for Women, Children and Youth Health, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marlon de Freitas Fonseca
- Department of Women’s Health, Fernandes Figueira National Institute for Women, Children and Youth Health, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
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