Intestinal obstruction secondary to postoperative adhesion formation in abdominal surgery. Review literature

Correa-Rovelo, José Manuel; Villanueva, Cleva; Medina-Santillán, Roberto; Carrillo-Esper, Raúl; Díaz-Girón-Gidi, Alejandro

doi:10.1016/j.circen.2015.09.031

Cited by 10 publications

(28 citation statements)

References 37 publications

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“…Polyethylene glycol (PEG) (Sprayshield, Integra LifeSciences, Plainsboro, NJ), formerly known as Spraygel and Auto-Cross-Linked gel polysaccharide (ACP) (Hyalobarrier, Nordic group, Paris, France) are also available in the European market. 10…”

Section: Discussionmentioning

confidence: 99%

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Therapeutic alternatives for the prevention of intra peritoneal adhesions

Colón¹,

Nieva

Treviño

et al. 2019

Int J Res Med Sci

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Intestinal adhesions are bands of fibrous tissue created by the intimate contact of two injured surface tissues; these appear in 93% of the patient undergoing intra-abdominal or gastrointestinal surgery. The comorbidities associated with the formation of adhesions have an impact on quality care offered to patients, leading to an increase in healthcare. Goals of this study was to perform a review that includes different therapeutic alternatives in basic and clinical research to prevent the formation of postoperative abdominal peritoneal adhesions. A bibliographic search was conducted in different databases including Pub med, Medline, Cochrane, science direct, from the years 2000 to 2018 using the keywords: gastrointestinal adhesions, small bowel obstruction, prophylaxis, treatment. Only experimental and clinical articles were selected. The development of peritoneal adhesions in most of the experimental studies occurred with cecal abrasion, studying the effect of biodegradable materials, drugs and gels such as mXG Hydrogel. Nanofiber membranes, agents created with recombinant technology such as periostin antisense oligonucleotide and aerosol applications such as polysaccharide 4DryField PH, are positioned to replace in the future the actual limited mechanical barriers application commonly used in abdominal surgery such as seprafilm and interceed. There are several anti-adhesion agents in experimental phase with different mechanism of action that could be used in the short term to prevent the formation of post-surgical intestinal adhesions. The inclusion of gastrointestinal surgeons in basic research is increasing and necessary with multidisciplinary collaboration. It is expected in short term the study and development of a greater number of materials to minimize tissue trauma and decrease the formation of post-surgical adhesions.

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Section: Discussionmentioning

confidence: 99%

“…The organization over time of the fibrin bands and their transformation into mature fibrous adhesions is what allows them to persist. 10…”

Section: Pathophysiology In the Formation Of Peritoneal Adhesionsmentioning

confidence: 99%

Therapeutic alternatives for the prevention of intra peritoneal adhesions

Colón¹,

Nieva

Treviño

et al. 2019

Int J Res Med Sci

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“…However, postsurgical adhesions are an almost inevitable consequence of abdominal surgery and are the largest single cause of intestinal obstruction [ 3 ]. Occurrence of adhesions after upper and lower abdominal surgery ranges from 67–93% [ 4 , 5 ]. The mortality rate due to postsurgical adhesions can be high, especially among the elderly [ 6 ], and these complications can cause chronic pain and female infertility [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Numerous strategies have been devised to prevent peritoneal adhesions, such as hydro flotation, barrier agents such as anti-adherence hyaluronic acid/carboxymethylcellulose, regenerated and expanded oxidised cellulose 0.5% in ferric hyaluronate and chlorine dioxide [ 5 ]. However, none of these strategies have been widely adopted due to poor efficacy or risk of adverse events [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Prevention of adhesions post-abdominal surgery: Assessing the safety and efficacy of Chitogel with Deferiprone in a rat model

et al. 2021

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Introduction Adhesions are often considered to be an inevitable consequence of abdominal and pelvic surgery, jeopardizing the medium and long-term success of these procedures. Numerous strategies have been tested to reduce adhesion formation, however, to date, no surgical or medical therapeutic approaches have been successful in its prevention. This study demonstrates the safety and efficacy of Chitogel with Deferiprone and/or antibacterial Gallium Protoporphyrin in different concentrations in preventing adhesion formation after abdominal surgery. Materials and methods 112 adult (8–10 week old) male Wistar albino rats were subjected to midline laparotomy and caecal abrasion, with 48 rats having an additional enterotomy and suturing. Kaolin (0.005g/ml) was applied to further accelerate adhesion formation. The abrasion model rats were randomized to receive saline, Chitogel, or Chitogel plus Deferiprone (5, 10 or 20 mM), together with Gallium Protoporphyrin (250μg/mL). The abrasion with enterotomy rats were randomised to receive saline, Chitogel or Chitogel with Deferiprone (1 or 5 mM). At day 21, rats were euthanised, and adhesions graded macroscopically and microscopically; the tensile strength of the repaired caecum was determined by an investigator blinded to the treatment groups. Results Chitogel with Deferiprone 5 mM significantly reduced adhesion formation (p<0.01) when pathologically assessed in a rat abrasion model. Chitogel with Deferiprone 5 mM and 1 mM also significantly reduced adhesions (p<0.05) after abrasion with enterotomy. Def-Chitogel 1mM treatment did not weaken the enterotomy site with treated sites having significantly better tensile strength compared to control saline treated enterotomy rats. Conclusions Chitogel with Deferiprone 1 mM constitutes an effective preventative anti-adhesion barrier after abdominal surgery in a rat model. Moreover, this therapeutic combination of agents is safe and does not weaken the healing of the sutured enterotomy site.

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“…Biomaterials, based on specific physical and chemical properties, can protect patients from developing intestinal adhesion (Li, Ren, & Zhang, 2018;Wu et al, 2017). However, which method is the most effective remains debated (Correa-Rovelo, Villanueva-Lopez, Medina-Santillan, Carrillo-Esper, & Diaz-Giron-Gidi, 2015).…”

Section: Introductionmentioning

confidence: 99%

Platelet‐rich fibrin prevents postoperative intestinal adhesion

Jia

Guo

et al. 2020

J Biomedical Materials Res

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Platelet‐rich fibrin (PRF) was prepared from the blood of BALB/C inbred mice to explore potential effects on postoperative intestinal adhesion. A murine model of intestinal adhesion characterized by abdominal wall defect/and cecum damage was established by scraping caecum serosa and cutting peritoneum and muscles in the abdominal wall. The wound was covered with PRF (group A), sodium hyaluronate (group B), or left alone (blank control; group C). All animals were monitored for 28 days. The incidence of adhesion was 35.0, 66.7, and 73.7% in groups A, B, and C, respectively. The incidence of adhesion in group A was significantly lower than that in group C (p < .05). Histopathologically, severity of fibrosis and the number of fibroblasts or inflammatory cells in group A were lower than those in groups B and C (p < .05), whereas the number of mesothelial cells was higher (p = .001). Furthermore, the severity of fibrosis and number of fibroblasts or inflammatory cells were lower in low grade than those in high grade of adhesion (p < .05), whereas the number of mesothelial cells was higher (p < .05). Collectively, PRF applied to abdominal surgery may reduce the incidence of intestinal adhesion by promoting proliferation of mesothelial cells whereas inhibiting proliferation of fibroblasts and infiltration of inflammatory cells.

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Intestinal obstruction secondary to postoperative adhesion formation in abdominal surgery. Review literature

Cited by 10 publications

References 37 publications

Therapeutic alternatives for the prevention of intra peritoneal adhesions

Therapeutic alternatives for the prevention of intra peritoneal adhesions

Prevention of adhesions post-abdominal surgery: Assessing the safety and efficacy of Chitogel with Deferiprone in a rat model

Platelet‐rich fibrin prevents postoperative intestinal adhesion

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