Adhesion prevention agents for gynaecological surgery: an overview of Cochrane reviews

Hindocha, Akshay; Beere, Lawrence; Dias, Sofia; Watson, Andrew; Ahmad, Gaity

doi:10.1002/14651858.cd011254.pub2

Cited by 33 publications

(22 citation statements)

References 37 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The AMSTAR tool has been used previously in > 170 methodological quality-assessment articles in other fields of research, including cardiology, 28,29 gastroenterology, 30 gynaecology, [31][32][33][34] neumology, 35,36 neurology, 37-39 neurosurgery, [40][41][42] general surgery, 43,44 urology, 45,46 radiology 47 and odontology. 48 Most studies achieved similar general conclusions to our study.…”

Section: Discussionmentioning

confidence: 99%

Systematic reviews and meta-analyses on psoriasis: role of funding sources, conflict of interest and bibliometric indices as predictors of methodological quality

et al. 2017

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Systematic reviews and meta-analyses on psoriasis: role of funding sources, conflict of interest and bibliometric indices as predictors of methodological quality

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Reoperation is more difficult, often takes longer, and is associated with a higher complication rate secondary to pelvic adhesions. 40 As mentioned earlier, adhesions might also be present because of previous in utero or neonatal hydrocolpos and ascites. Adhesions have been associated with dyspareunia, infertility, and bowel obstruction.…”

Section: Pelvic Adhesionsmentioning

confidence: 90%

“…In this patient population, 4 patients were noted to have adhesive disease that required modification of the standard surgical technique to avoid injury to bladder and/or bowel. 11,17,19,40,41 This modification of a standard surgical cesarean section has also been described in other complex pelvic anomalies such as bladder exstrophy. 41 In 1 case, a transvesical cesarean section was performed because of multiple adhesions and abnormal position of the bladder.…”

Section: Pelvic Adhesionsmentioning

confidence: 95%

“…Adhesions have been associated with dyspareunia, infertility, and bowel obstruction. 40 Patients and their families should be counseled that adhesive disease might increase the complexity of a cesarean section. In this patient population, 4 patients were noted to have adhesive disease that required modification of the standard surgical technique to avoid injury to bladder and/or bowel.…”

Section: Pelvic Adhesionsmentioning

confidence: 99%

See 1 more Smart Citation

Obstetrical Outcomes in Adult Patients Born with Complex Anorectal Malformations and Cloacal Anomalies: A Literature Review

Vilanova-Sánchez

McCracken

Halleran

et al. 2019

Journal of Pediatric and Adolescent Gynecology

View full text Add to dashboard Cite

a b s t r a c tPatients born with complex anorectal malformations often have associated M€ ullerian anomalies, which might affect fertility and obstetrical outcomes. Other vertebral-anorectal-tracheoesophageal-renal-limb associations, such as renal or cardiac anomalies, could also affect pregnancy intention, fertility rates, and recommendations about mode of delivery or obstetrical outcomes. Associated conditions present at birth, like hydrocolpos, could also potentially affect fertility. Depending on the complexity of the anomaly, primary reconstruction might include vaginoplasty, vaginal interposition, perineal body reconstruction, and extensive pelvic dissection. After the initial reconstruction, patients might have multiple additional surgeries for stoma reversal, bladder augmentation, and creation of conduits, all with potential for pelvic adhesions. Pregnancy intention, fertility rates, mode of delivery, and obstetrical outcomes data are limited in this patient population, making it challenging to counsel patients and their families. We sought to evaluate all available literature in an attempt to better counsel families. A PubMed literature search was undertaken to review this topic. Search terms of "cloaca," "anorectal malformation," "pregnancy," "cloacal exstrophy," "vaginal delivery," and "cesarean section" were used and citation lists from all identified articles were checked to ensure that all possible articles were included in the review. We also outline comorbidities from the fetal period to adulthood that might affect reproductive health. Of the articles on anorectal and cloacal anomalies, 13 reports were identified that covered obstetrical outcomes. They were in patients with previous anorectal malformation, cloaca, and cloacal exstrophy repair. Twenty-four pregnancies were reported in 16 patients. Two ectopic pregnancies, 5 spontaneous miscarriages, 1 triplet pregnancy, and 16 singleton pregnancies were reported with a total of 19 live births. Regarding the method of conception, 15/18 pregnancies occurred spontaneously and 3/18 were via assisted reproductive technology with in vitro fertilization. There were 19 live births, of which at least 8 were preterm. M€ ullerian anatomy was reported in 8 of 13 articles. Only 2 patients underwent vaginal delivery (1 patient with repaired cloaca malformation had an operative vaginal delivery and 1 patient with repaired imperforate anus with rectovaginal fistula had a normal spontaneous vaginal delivery). The remaining patients all underwent a cesarean section. There were no reported cases of maternal mortality, and maternal morbidity was limited to recurrent urinary tract infections and worsening chronic kidney disease. There is a paucity of information regarding obstetrical outcomes in adult anorectal and cloaca patients. However, patients with previous cloacal repairs have achieved pregnancy spontaneously, as well as with in vitro fertilization. Patients with repaired cloacal malformations are at increased risk of preterm birth and cesarean delivery. Most p...

show abstract

“…In gynecological surgery, especially in procedures with high risk of adhesion formation, such as ovarian surgery, endometriosis and tubal surgery, and myomectomy, good surgical practice along with adoption of adhesion-reducing agents is conducive to preventing adhesion formation 2. At present, many anti-adhesion agents, such as oxidized regenerated cellulose (ORC),5 hyaluronic acid,6 hyaluronate–carboxymethyl cellulose,7 and icodextrin,5,8,9 are available for use in the clinic. The most frequently adopted treatment approach for postoperative adhesions is adhesiolysis.…”

Section: Introductionmentioning

confidence: 99%

Hyaluronate acid and oxidized regenerated cellulose prevent adhesion reformation after adhesiolysis in rat models

Zhang

Liu

Yang

et al. 2016

DDDT

View full text Add to dashboard Cite

Postsurgical adhesion formation is the most common complication in abdominal and pelvic surgery. Adhesiolysis is the most commonly applied treatment for adhesion formation but is often followed by adhesion reformation. Therefore, an efficient strategy should be adopted to solve these problems. This study aimed to explore whether hyaluronic acid and oxidized regenerated cellulose (ORC) could prevent adhesion formation and reformation. Thirty female Sprague Dawley rats were randomly divided into three groups (n=10 each) and subjected to different treatments during the first and second surgery. The control group was treated with isotonic sodium chloride, the ORC group was treated with ORC (1.5×1 cm), and the medical sodium hyaluronate (MSH) group was treated with 1% MSH (0.5 mL). At 2 weeks after the first surgery, adhesion scores in the MSH group (1.90±0.99) and the ORC group (1.40±0.97) were significantly lower than those in the control group (3.00±0.82) (P=0.005). Similarly, 2 weeks after the second surgery, adhesion scores in the MSH group (2.00±0.82) and the ORC group (1.50±1.27) were significantly lower than those in the control group (3.50±0.53) (P=0.001). In addition, body weights in the MSH group and the ORC group did not change significantly, whereas the control group showed a consistent decrease in body weight during the experiment. Histological examination revealed that inflammatory infiltration was involved in both adhesion formation and reformation. In conclusion, hyaluronic acid and ORC were both efficient in reducing adhesion formation and reformation in the rat model.

show abstract

Adhesion prevention agents for gynaecological surgery: an overview of Cochrane reviews

Cited by 33 publications

References 37 publications

Systematic reviews and meta-analyses on psoriasis: role of funding sources, conflict of interest and bibliometric indices as predictors of methodological quality

Systematic reviews and meta-analyses on psoriasis: role of funding sources, conflict of interest and bibliometric indices as predictors of methodological quality

Obstetrical Outcomes in Adult Patients Born with Complex Anorectal Malformations and Cloacal Anomalies: A Literature Review

Hyaluronate acid and oxidized regenerated cellulose prevent adhesion reformation after adhesiolysis in rat models

Contact Info

Product

Resources

About