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Effects of intraperitoneal mitomycin C adsorbed on activated carbon on adhesion formation and mesothelial cells in
M Jansen1, J Fass, E Langejürgen
1Department of Surgery, University Clinic RWTH, Aachen, Germany.
Objective:
To investigate the incidence of adhesions after intraperitoneal instillation of mitomycin C adsorbed on activated carbon (MMC-CH).
Design:
Animal and laboratory studies.
Setting:
University hospital, Germany.
Animals:
90 Sprague-Dawley rats.
Interventions:
Laparotomy, small bowel anastomosis, and intraperitoneal instillation of saline (controls, n = 27), activated carbon alone (n = 24) or MMC-CH (n = 26). Cultures of monolayers of human mesothelial cells.
Main Outcome Measures:
Measurements of adhesions by planimetry. Toxicity of mitomycin C alone and charcoal alone in mesothelial cell monolayers as reflected by cell proliferation and measurement of lactate dehydrogenase activity. Concentrations of plasminogen activator (tPA) and plasminogen activator inhibitor 1 (PAI-1) as measures of the fibrinolytic activity of mesothelial cells.
Results:
Both activated carbon and MMC-CH caused a significant increase of adhesion formation in rats. Activated carbon also reduced the fibrinolytic activity of mesothelial cells, and mitomycin C caused concentration-dependent cytotoxicity in vitro.
Conclusions:
Activated carbon combined with high concentrations of mitomycin C may cause intraperitoneal infective complications by increasing the rate of adhesion formation and reducing the fibrinolytic activity of mesothelial cells. We recommend a new absorbable carrier for intraperitoneal chemotherapy.
Insights
Activated carbon combined with mitomycin C increased adhesion formation and reduced fibrinolytic activity in rats. Researchers suggest exploring new absorbable carriers for intraperitoneal chemotherapy to mitigate these risks.
Area of Science:
- Surgical research
- Oncology
- Biomaterials science
Background:
- Intraperitoneal chemotherapy is used to treat various cancers.
- Adhesion formation is a common complication after abdominal surgery.
- Mitomycin C adsorbed on activated carbon (MMC-CH) is a potential agent for intraperitoneal chemotherapy.
Purpose of the Study:
- To investigate the incidence of adhesions following intraperitoneal instillation of mitomycin C adsorbed on activated carbon (MMC-CH).
Main Methods:
- Animal and laboratory studies were conducted.
- 90 Sprague-Dawley rats underwent laparotomy and small bowel anastomosis.
- Rats received intraperitoneal instillation of saline, activated carbon alone, or MMC-CH.
Main Results:
- Both activated carbon and MMC-CH significantly increased adhesion formation in rats.
- Activated carbon reduced mesothelial cell fibrinolytic activity.
- Mitomycin C demonstrated concentration-dependent cytotoxicity in vitro.
Conclusions:
- Activated carbon combined with high mitomycin C concentrations may lead to intraperitoneal infective complications.
- Increased adhesion formation and reduced fibrinolytic activity contribute to these complications.
- The study recommends developing a new absorbable carrier for intraperitoneal chemotherapy.
