Postoperative inflammation in the abdominal cavity increases adhesion formation in a laparoscopic mouse model

Objective: To investigate acute inflammation in the peritoneal cavity in adhesion formation. Design: Prospective randomized, controlled trial. Setting: University laboratory research center. Animal(s): 9- to 10-week-old BALB/c female mice. Intervention(s): In a laparoscopic mouse model, acute inflammation in the peritoneal cavity evaluated in CO₂ pneumoperitoneum enhaced adhesions, by CO₂ pneumoperitoneum plus manipulation, and in the latter group plus dexamethasone. Main Outcome Measure(s): Qualitative and quantitative adhesion scores and an acute inflammation score (neoangiogenesis, diapedesis, and leukocyte accumulation). Result(s): Adhesions at the lesion site were enhanced by the CO₂ pneumoperitoneum, further enhanced by manipulation, and decreased by the administration of dexamethasone. The acute inflammation scores (total, neoangiogenesis, diapedesis, and leukocyte accumulation) strongly correlated with the total adhesion score. Inflammation scores were similar at both the surgical lesion and the parietal peritoneum. Conclusion(s): Acute inflammation of the entire peritoneum cavity is an important mechanism involved in adhesion formation and enhances adhesion formation at the lesion site.