Genetic and Epidemiological Similarities, and Differences Between Postoperative Intraperitoneal Adhesion Development and Other Benign Fibro-proliferative Disorders

Awonuga, Awoniyi O.; Chatzicharalampous, Charalampos; Thakur, Mili; Rambhatla, Anupama; Qadri, Farnoosh; Awonuga, Modupe; Saed, Ghassan M.; Diamond, Michael P.

doi:10.1007/s43032-021-00726-9

Cited by 6 publications

(1 citation statement)

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“…Future trials on adhesion formation should consider the fact that adhesion formation might be different in every disease. Although yet unclear, genetic predisposition to adhesion development apparently exists (Awonuga et al, 2022;Thakur et al, 2021). Although endometriosis is not simply "an ectopic endometrium", recent studies have demonstrated that it is a disease heavily related to the eutopic endometrium (Laganà and Naem, 2022).…”

Section: Discussionmentioning

confidence: 99%

Postoperative Peritoneal Granulomatous Inflammation After the Application of Potato Starch-Based Anti-Adhesive Agent in Laparoscopic Endometriosis Surgery

Krentel,

Naem,

Tannapfel

et al. 2023

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Background: Endometriosis is a chronic inflammatory oestrogen-dependent disease. It is characterised by elevated inflammatory markers in the peritoneal milieu with subsequent adhesiogenesis. Nowadays, excisional, and ablative surgeries are considered the main treatment of endometriosis, and adhesiolysis is being performed almost routinely during these procedures. Postoperative adhesion formation is a significant concern for many surgeons, especially as endometriosis patients are assumed to be predisposed to adhesiogenesis. In order to minimise adhesiogenesis after endometriosis surgery, the usage of different barrier methods have been discussed in the literature. Recent studies aim to investigate the effect of potato starch preparations on adhesion formation in endometriosis patients. Objectives: We aim to describe the findings of a second-look laparoscopy on patients who received a starch-based anti-adhesive agent. Materials and Methods: We present a retrospective case series that included the medical, surgical, and histopathologic data of three patients. Main Outcome Measures: Intraperitoneal adhesion formation and peritoneal inflammation. Results: All three patients had de-novo adhesions during the second-look laparoscopy. Pathological examination revealed noncaseating granulomatosis of the peritoneum in all patients. Conclusion: The use of potato starch-based agents as a peritoneal adhesion prophylaxis in laparoscopic endometriosis surgery could lead to granulomatous peritoneal inflammation. Correct application by avoiding powder remnants through complete rinsing and transformation to gel seems to be an important factor to avoid this adverse effect. What is new? We aim to highlight that potato starch-based anti-adhesive agents similar to the one used in this study could be a cause of adhesiogenesis and peritoneal inflammation.

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Section: Discussionmentioning

confidence: 99%