Abdominal adhesions: intestinal obstruction, pain, and infertility

Vrijland, W. W.; Jeekel, J.; Geldorp, H. J. van; Swank, Dingeman J.; Bonjer, H. Jaap

doi:10.1007/s00464-002-9208-9

Cited by 160 publications

(128 citation statements)

References 65 publications

(31 reference statements)

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“…As principais conseqüências da formação de aderências são infertilidade, obstrução intestinal, dor pélvica crônica e o maior risco associado às reoperações (perfuração de vísceras ocas e de vasos intra-abdominais) [18][19][20][21] . A torção tubária, a estenose do suprimento ovariano e aderências intra-uterinas estão entre as maiores conseqüências das aderências e estimase que estas podem representar causa da infertilidade em até 40% dos casos 22 .…”

Section: Conseqüências Da Formação De Aderênciasunclassified

Impacto da vídeocirurgia na prevenção de aderências

Araújo

Caravatto

Chang

et al. 2006

Rev bras. colo-proctol.

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Uma das vantagens aventadas da vídeo-cirurgia é a possibilidade de formar menos aderências pós-operatórias. As evidências deste efeito resultam de trabalhos clínicos e experimentais, mas o real impacto desta via de acesso neste sentido ainda não foi comprovado. O objetivo da presente revisão foi avaliar as evidências científicas disponíveis sobre o assunto. Material e Métodos: revisão da literatura pertinente. Resultados: As aderências pós-operatórias foram analisadas no sítio da operação e nas incisões praticadas, porém existem poucas informações sobre aderências em locais não operados. Aderências pós-operatórias são menos freqüentes ou intensas quando se considera a via de acesso por vídeo. A despeito deste dado experimental, os desfechos clínicos de menor dor pélvica, menor número de admissões ou reoperações por obstrução intestinal e menor ocorrência de infertilidade ainda não podem ser claramente atribuídos a esta via de acesso, especialmente quando se consideram as cirurgias laparoscópicas avançadas, uma vez que nesta situação existe equivalência de área cruenta nas duas vias de acesso, à exceção da área associada às incisões. Conclusões: A via de acesso por vídeo está associada a menor formação de aderências, mas não protege de complicações relacionadas à sua ocorrência. Técnica operatória adequada e o uso de barreiras provavelmente estão mais fortemente associadas à menor formação de aderências do que a via de acesso aberta empregada para a realização das operações abdominais e pélvicas.
Laparoscopic surgery seems to be associated with less adhesion formation and complications associated to surgical access when compared to laparotomy. Experimental and clinical evidence confirm this hypothesis but the impact of laparoscopy on adhesion formation and its complications remains undetermined. The present article aims at reviewing the evidence on this issue. Method: literature review. Results: Postoperative adhesions were evaluated at operation site and at surgical scars. Nevertheless, results on adhesion formation at sites distant from them are still unavailable. Adhesion formation was less common or reduced when laparoscopic access was compared to conventional surgery. Main adverse outcomes regarding adhesion formation are pelvic pain, infertility, and intestinal obstruction. There is little evidence of reduced incidence of these adverse outcomes after laparoscopic surgery when compared to conventional access and there may be none at all when major laparoscopic operations are considered. This finding may be due to a similar extent of dissection after conventional or advanced video operations with the exception of the adhesions related to the incisions. Conclusions: Laparoscopic surgery is associated to less adhesion formation but may not protect from adverse outcomes expected after abdominal operations. Adequate surgical technique and the use of commercially available adhesion barriers may be major determinants from adhesions formation and its consequences

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Section: Conseqüências Da Formação De Aderênciasunclassified

Impacto da vídeocirurgia na prevenção de aderências

Araújo

Caravatto

Chang

et al. 2006

Rev bras. colo-proctol.

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“…Las adherencias peritoneales (AP) pueden ser definidas como bandas fibrosas anormales entre órganos y/o tejidos en la cavidad abdominal, que normalmente están separados [1][2][3] . La gran mayoría de estas son adquiridas como resultado de una injuria peritoneal (ya sea incisión, cauterización, sutura u otro tipo de trauma) siendo la causa más común la cirugía 4 .…”

Section: Introductionunclassified

Prevención de adherencias peritoneales postoperatorias mediante uso de antagonista de receptores de neurokinina tipo 1

González-Torres

et al. 2010

Rev Chil Cir

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Peritoneal adhesions prevention. Neurokinin-1 receptor antagonistBackground: The fibrinolytic activity plays an important role in Peritoneal Adhesions (PA) development. It´s well known that de substance P decreased the fibrinolysis by binding the neurokinin-1 receptor, improving the PA formation. Objectives: To evaluate the effectiveness of intraperitoneal treatment with a Neurokinin-1 receptor antagonist (NK-R1A) in peritoneal adhesion prevention in animal model. Materials and Methods: In 40 male wistar rats, PA were induced, and then randomly assigned to 2 groups: A group treated with Aprepitant (NK-R1A), and a control group. The animals were killed at 7 or 14 postoperative day, and the number, severity and histopathology of PA were evaluated. Results: NK-R1A decreased the number (40% less) and severity (p = 0.001) of PA when compare to control group. The NK-R1A group had less PA in manipulated and no manipulated organs during surgery. Besides presented less fibrosis (p = 0.001), less inflamation (p = 0.005) and less vascular proliferation (p = 0.047) than control group. Conclusions: The NK-R1A is effective as in PA prevention.

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“…Adhesions occur in more than 90% of the patients who have undergone abdominal surgeries [14] and can lead to conditions such as bowel obstruction [1,15], chronic abdominal and pelvic pain [16], and infertility [24]. In addition, subsequent laparotomies may carry an increased risk of complications due to the adhesion of visceral organs [9,12].…”

mentioning

confidence: 99%

Trehalose May Prevent Postsurgical Adhesions in a Rabbit Model of Hysterotomy

Fujino

Lee

Suzuki³

et al. 2011

The Journal of Veterinary Medical Science

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ABSTRACT. The adhesion-preventing effect of trehalose in visceral organs was evaluated in a rabbit model. All rabbits underwent a hysterotomy, during which mild abrasion and desiccation was induced on the surfaces of visceral organs. In the control group, the intestines were kept dry during hysterotomy. In the saline and trehalose groups, saline solution and 7% trehalose solution, respectively, were sprayed on the organ surfaces. Adhesion formation on organ surfaces on which abrasion and desiccation were induced declined significantly in the trehalose group compared with the other groups. In contrast, at the hysterotomy site, there was no significant difference in adhesions between groups, suggesting that trehalose prevents adhesions in organs that have developed minor inflammation by abrasion and desiccation.

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Abdominal adhesions: intestinal obstruction, pain, and infertility

Cited by 160 publications

References 65 publications

Impacto da vídeocirurgia na prevenção de aderências

Impacto da vídeocirurgia na prevenção de aderências

Prevención de adherencias peritoneales postoperatorias mediante uso de antagonista de receptores de neurokinina tipo 1

Trehalose May Prevent Postsurgical Adhesions in a Rabbit Model of Hysterotomy

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