The role of neutrophils in the formation of peritoneal adhesions

The most common cause of intraperitoneal adhesions which may result in infe rtility and intestinal obstruction is previous abdominal surgery. Surgical trauma of the peritoneum in the absence of infection elicits a rapid and tr ansient influx of polymorphonuclear leukocytes (PMN) into the peritoneal ca vity, The role of neutrophils in intraperitoneal adhesion formation has not been studied. We aimed to study the effects of PMN counts and PMN function s on peritoneal adhesion formation. Forty peritoneal adhesion-induced rats were randomly divided into three groups; group I, receiving saline; group L I, receiving cyclophosphamide; and group III, receiving granulocyte-macroph age colony-stimulating factor (GM-CSF), In all groups, peritoneal lavage wa s performed to determine PMN counts the day after adhesion induction. Blood neutrophil counts and neutrophil functions were also determined. Adhesions were evaluated blindly 14 days after the operation. Adhesion tissue sample s were microscopically evaluated. Tissue hydroxyproline and collagen concen trations were measured. The neutrophil counts and phagocytosis significantl y increased in group III and neutrophil counts decreased in group II (P < 0 .05), The score of adhesion formation in group II was significantly less th an that in groups I and III (P < 0.05). Hydroxyproline concentrations of ad hesion tissue were significantly decreased in group II when compared with g roup III (P < 0.05). The present study shows that neutropenia lowers the de gree of postoperative adhesion formation. It is concluded that PMN may have a role to play in modulating post-operative adhesion formation.