Postoperative intraperitoneal adhesion pathophysiology

Duron, Jean‐Jacques

doi:10.1111/j.1463-1318.2007.01343.x

Cited by 92 publications

(81 citation statements)

References 110 publications

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“…It involves a cascade of cellular, biochemical and immunological factors. [25] Inflammatory cellular activity in mesothelial regeneration and the alteration of the peritoneal fibrinolytic system are considered as the main pathways of adhesion formation. [25] According to our findings, MB application reduces adhesion formation after peritonitis based on alterations determined in adhesion scores, whereas it impairs wound healing as depicted by reduction in serum TNF-α and tissue 5-HP levels.…”

Section: Discussionmentioning

confidence: 99%

The effects of methylene blue on adhesion formation in a rat model of experimental peritonitis

Kalaycı¹,

Eroğlu²,

Kubilay³

et al. 2011

Ulus Travma Acil Cerrahi Derg

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Section: Discussionmentioning

confidence: 99%

The effects of methylene blue on adhesion formation in a rat model of experimental peritonitis

Kalaycı¹,

Eroğlu²,

Kubilay³

et al. 2011

Ulus Travma Acil Cerrahi Derg

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“…Both the peritoneal injury and the presence of foreign material enhance adhesion formation: these factors induce increased vascular permeability followed by an inflammatory response with a simultaneous release of inflammatory proteins (Zinther et al 2010). Several investigations have revealed that surgery leads to ingrowths of fibroblasts into the fibrin matrix, depositing collagen and resulting in the formation of connective tissue and adhesion (fibrous bands) between the injured peritoneal surfaces (Holmdahl 1997;Duron 2007). As the aim of our study was to investigate the feasibility of laparoscopic abomasal cannulation, which would be an important research tool in animal nutrition research, and most such research ends before removal of the cannula, we did not investigate the time of persistence of the adhesions afterwards.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic abomasal cannulation in sheep

Zhang¹,

Fu²,

Y.³

et al. 2015

Vet. Med. - Czech

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Abomasal cannulation, an important research tool in experimental procedures, provides a method for the placement of an abomasal cannula in sheep. The aim of this study was to describe a technique for laparoscopic abomasal cannulation in sheep. It was performed in six anaesthetised sheep positioned in dorsal recumbency using three portals in the abdomen. The first absorbable traction suture was placed 1 cm cranial to the determined abomasal cannula site. A stab incision was made with a laparoscopic monopolar hook electrode in the middle of a purse-string suture placed around the abomasal cannula site. The T-shaped cannula was inserted into the abomasum lumen through the stab incision, and the second traction suture was then placed 1 cm caudal to the abomasal cannula site. The T-shaped abomasal cannula was pulled out of the abdominal cavity through the exit wound located 3-5 cm lateral and 10-12 cm cranial to the right side of the umbilicus. The two traction sutures were tied. The T-shaped cannula was secured to the skin with a finger-trap suture. Repeat laparoscopy was performed 1 month later. Firm adhesion between the abomasum and abdominal wall was observed in all sheep, with no evidence of leakage or peritonitis. No major intraoperative or postoperative complications were encountered. The median surgical time was 49 min, with a range from 42 to 58 min. The abomasal contents were collected easily. In conclusion, laparoscopic abomasal cannulation is safe and easy to perform. Its low complication rates and the "ideal" placement of the tube into the abomasum make it an especially attractive alternative to traditional surgical abomasal cannulation in veterinary practice.

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“…Aproximadamente 60 ml de líquido peritoneal son producidos por hora, pero la cavidad peritoneal normalmente contiene sólo una pequeña cantidad de este líquido (Browning 2005). El líquido peritoneal normalmente contiene muchas de las proteínas plasmáticas, dentro de las cuales el fibrinógeno interviene durante el proceso inflamatorio intraperitoneal, especialmente en el período intra y postoperatorio, en donde se forman las adherencias (Duron 2007). De acuerdo a Hanson y col (1992), el líquido peritoneal refleja el estado patofisiológico de las superficies mesoteliales parietales y viscerales, por lo cual manipulaciones adicionales del peritoneo asociadas a resección y anastomosis de dos segmentos de intestino tendrían pequeñas consecuencias comparado con el trauma inducido en una celiotomía exploratoria.…”

Section: Introductionunclassified

“…En mamíferos machos, forman un espacio cerrado, mientras que en hembras existe una potencial comunicación al exterior vía cuernos uterinos. El peritoneo parietal se encuentra inervado por ramas de nervios espinales y contiene nociceptores térmicos, químicos y mecánicos (Duron 2007), los cuales son capaces de procesar estímulos dolorosos agudos localizados (Hollinshead 1953, Browning 2005. El peritoneo visceral, en contraste, está inervado por aferentes simpatéticos y reacciona a estímulos producidos por distensión, estiramiento, isquemia e inflamación (Browning 2005).…”

Section: Introductionunclassified

Adherencias abdominales postquirúrgicas en equinos: patofisiología, prevención y tratamiento

2009

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SUMMARYDespite the great number of human and veterinary medicine research, abdominal adhesions are still a big concern and a frequent complication for surgeons. The development of abdominal adhesions is a complex and dynamic process that involves a series of different mechanisms that start with an inflammatory process and tissue damage, followed by a fibrinogenic and fibrinolytic unbalance and ends with a change from fibrin deposit to fibrous tissue. In horses, after small intestine surgeries, adhesion incidence ranges from 14 to 22%. It is the most frequent cause of recurrent abdominal pain and the second cause for repeat celiotomy. Nevertheless, when all equine abdominal surgeries are included, the incidence of postoperative adhesions approximates 5%. A better understanding of the cellular mechanisms of adhesion formation and reformation should help to develop better prevention methods. Currently, a variety of prevention measures and treatments, most of them aiming to reduce or avoid adhesions formation, are used in veterinary medicine. The aim of this review is to gather most of the available information and the latest research explaining the pathophysiology, prevention and treatment of abdominal adhesions in horses.Palabras clave: equinos, adherencias abdominales, postquirúrgicas.Key words: equine, abdominal adhesions, post-surgical. INTRODUCCIÓNLas enfermedades gastrointestinales continúan siendo una de las mayores preocupaciones en la industria de los equinos y una gran proporción de caballos son derivados a centros quirúrgicos debido a desórdenes abdominales (Smith y col 2005). Estas patologías incluyen desórdenes de la motilidad y obstructivos, siendo comunes tanto en medicina humana como en medicina veterinaria. Estas alteraciones tienden a ser clínicamente importantes en ambas disciplinas, con un extensivo impacto en la práctica veterinaria así como también en la salud pública humana (Hudson y Dunlop 2005). Se ha descrito que la formación de adherencias es la causa más común de episodios repetidos de cólico luego de cirugías de intestino delgado en caballos y es la segunda causa más común de celiotomías repetidas en equinos después de cirugías de cólico por otras causas (Baxter y col 1989, Parker y col 1989, Baxter 1991, Mair y Edwards 2003). Estos estudios contrastan con Gorvy y col (2008), quienes no encontraron evidencia que sugiriera a partir del hecho de que las lesiones de intestino delgado o grueso en una primera cirugía lleven a la formación de adherencias. Adicionalmente, se detalla que posterior a cirugías de intestino grueso el 36% de las adherencias produjeron obstrucción de intestino delgado. Varios estudios realizados en los últimos diez años describen que las adherencias postquirúrgicas se presentan entre un 6% y un 27% en equinos con obstrucción de intestino delgado o como un hallazgo de una segunda cirugía de abdomen (Freeman y col 2000, Mair y Smith 2005, Gorvy y col 2008).En este sentido, estudios realizados previamente indican un 14% de adherencias postquirúrgicas (Phillips y Walmsl...

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Postoperative intraperitoneal adhesion pathophysiology

Cited by 92 publications

References 110 publications

The effects of methylene blue on adhesion formation in a rat model of experimental peritonitis

The effects of methylene blue on adhesion formation in a rat model of experimental peritonitis

Laparoscopic abomasal cannulation in sheep

Adherencias abdominales postquirúrgicas en equinos: patofisiología, prevención y tratamiento

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