Fertility and Sterility vol:82 Suppl 3 pages:1149-53
OBJECTIVE: To evaluate the role of vascular endothelial growth factor receptor-1 (VEGFR-1) in adhesion formation after laparoscopic surgery. DESIGN: Prospective, randomized study. SETTING: Academic research center. ANIMAL(S): Forty female Swiss mice. INTERVENTION(S): Adhesions were induced by standardized lesions during laparoscopy. The CO2 pneumoperitoneum was maintained for the minimum time needed to perform the lesions (10 minutes) or for a longer period (60 minutes) to evaluate basal adhesions and pneumoperitoneum-enhanced adhesions, respectively. Mice were treated either with IgG or with antibodies against VEGFR-1. MAIN OUTCOME MEASUREMENT(S): Adhesions were quantitatively and qualitatively scored after 7 days during laparotomy. RESULT(S): In IgG-treated mice, 60 minutes of CO2 pneumoperitoneum increased basal adhesions. In VEGFR-1 antibody-treated mice, basal adhesions were similar to the control group and 60 minutes of CO2 pneumoperitoneum did not increase adhesions. Therefore, in these mice, pneumoperitoneum-enhanced adhesions were lower than in IgG-treated mice. CONCLUSION(S): The data confirm that CO2 pneumoperitoneum is a cofactor in adhesion formation and demonstrate that VEGFR-1 plays a role in pneumoperitoneum-enhanced adhesions, which is consistent with a role of placental growth factor, VEGF-A, and VEGF-B in pneumoperitoneum-enhanced adhesions. These observations give new insight into the pathogenesis of adhesion formation.