Classification of Adnexal Adhesions: A Proposal and Evaluation of Its Prognostic Value

Hulka, Jaroslav F.; Omran, K.F.; Berger, Gary S.

doi:10.1016/s0015-0282(16)43693-9

Cited by 74 publications

(5 citation statements)

References 5 publications

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“…Conception after laparoscopic surgery was favorably influenced by the desire to procreate, the absence of co-morbidity, the tubal score, the quality of the surgical procedure and the subsequent follow-up by a gynecologist ( Table 3). The results indicate that three factor scores are associated with (almost) complete pregnancy failure: many adhesions [21], fixed adhesions, and a thick tubal wall. Pregnancy success is mainly related to a normal endosalpinx and to the absence of adhesions [11] [22].…”

Section: Discussionmentioning

confidence: 91%

Fertility after Neosalpingostomy through Laparoscopic Way in Point “G” Teaching Hospital

Keita¹,

Traoré²,

Soumare³

et al. 2019

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The endoscopic surgery is actually the golden standard for the management of infertility. Its results look better than classical surgery. The aim of the study was to assess the fertility rate among infertile women who have undergone a laparoscopic distal tubal plasty and to estimate factors influencing this fertility. From January 2007 to December 2016 a descriptive and analytical cross sectional retrospective study was conducted in the departments of general and laparoscopic surgery of the Point "G" Teaching Hospital in Bamako, Mali. Clinical records of 120 laparoscopic patients with distal tubal occlusion who have undergone a neosalpingostomy were collected. Average period of infertility was 6.7 years (from 1 to 25 years), and the average duration before laparoscopic surgery was 5 years. Main abnormalities were: 50 cases of bilateral tubal distal occlusion (41.7%), 14 patients with unilateral tubal distal occlusion (11.7%), 44 cases of bilateral hydrosalpinx (36.6%) and 12 cases with unilateral occlusion (10.0%). Seventeen patients had adhesions (14.1%) including 4.0% of tubo-peritoneal adhesions, 35.5% of tubo-ovary adhesions and Fitz Hugh and Curtis syndrom adhesions in 17.7% of cases. More than half of the patients (58.0%) had a grade II tubal score. Neosalpingostomy had led to bilateral tubal repermeabilization among 60.0% of the patients. Thirty two point five percent (39/120) pregnancies have been observed after the management. Conception probability was null after the 4 th post operative year. The majority of pregnancies have been observed in the 11 th month after laparoscopic management. During the follow-up, thirty one patients had intrauterine pregnancy (79.5%), four ectopic pregnancies and three miscarriages.

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Section: Discussionmentioning

confidence: 91%

Fertility after Neosalpingostomy through Laparoscopic Way in Point “G” Teaching Hospital

Keita¹,

Traoré²,

Soumare³

et al. 2019

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“…After the expected observation period (2 weeks), all animals were sacrificed by cervical dislocation. As previously described, incisions were reopened, and postoperative adhesion was scored: score 0: no adhesion, score 1: mild adhesion, score 2: local moderate adhesion, score 3: moderate and extensive adhesion, score 4: severe adhesion, inseparable . For subsequent staining experiments, peritoneal tissues from the wounded region and heart, lung, liver, spleen, and kidney were collected in 4% paraformaldehyde.…”

Section: Methodsmentioning

confidence: 99%

Nanofiber Hydrogel Drug Delivery System for Prevention of Postsurgical Intestinal Adhesion

Zhao,

Zhu,

Zhang

et al. 2024

ACS Biomater. Sci. Eng.

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Intestinal adhesion is one of the complications that occurs more frequently after abdominal surgery. Postsurgical intestinal adhesion (PIA) can lead to a series of health problems, including abdominal pain, intestinal obstruction, and female infertility. Currently, hydrogels and nanofibrous films as barriers are often used for preventing PIA formation; however, these kinds of materials have their intrinsic disadvantages. Herein, we developed a dual-structure drug delivery patch consisting of poly lactic-co-glycolic acid (PLGA) nanofibers and a chitosan hydrogel (NHP). PLGA nanofibers loaded with deferoxamine mesylate (DFO) were incorporated into the hydrogel; meanwhile, the hydrogel was loaded with anti-inflammatory drug dexamethasone (DXMS). The rapid degradation of the hydrogel facilitated the release of DXMS at the acute inflammatory stage of the early injury and provided effective anti-inflammatory effects for wound sites. Moreover, PLGA composite nanofibers could provide sustained and stable release of DFO for promoting the peritoneal repair by the angiogenesis effects of DFO. The in vivo results indicated that NHP can effectively prevent PIA formation by restraining inflammation and vascularization, promoting peritoneal repair. Therefore, we believe that our NHP has a great potential application in inhibition of PIA.

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“…The adhesion severity score was classified on a scale of 0−4 as previously described. 29 Severe adhesion between the abdominal wall and cecum was detected in the no-treatment group, and it was impossible to peel apart the adhesions. The average adhesion severity score for the notreatment group was 3.6 (Figure 6b).…”

Section: T H Imentioning

confidence: 98%

“…Representative images of the cecum 14 days after treatment with sprayable β-chitin NF hydrogels and solid-state Seprafilm are shown in Figure a. The adhesion severity score was classified on a scale of 0–4 as previously described . Severe adhesion between the abdominal wall and cecum was detected in the no-treatment group, and it was impossible to peel apart the adhesions.…”

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confidence: 99%

Thixotropic β-Chitin Nanofiber Hydrogel with a Living Body-Responsive Self-Hardening Property and Its Application as a Sprayable Antiadhesion Barrier

Nagahama,

Tobiishi,

Ueda

et al. 2023

ACS Appl. Bio Mater.

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Considering recent advances in surgical techniques, sprayable antiadhesion barriers that are compatible with minimally invasive procedures are needed. However, the relatively low mechanical stiffness of the current thixotropic reversible sol-to-gel transition hydrogels has hindered their medical application. Herein, we show a thixotropic sprayable β-chitin nanofiber hydrogel that spontaneously lost the thixotropic property in response to the environments within the living body. Furthermore, interactions between hydrogels and the biological environment result in a significant increase in mechanical stiffness. Due to these advantageous properties, β-chitin nanofiber hydrogels administered by spray prevent postoperative abdominal adhesions and are thus promising sprayable antiadhesion barriers.

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Classification of Adnexal Adhesions: A Proposal and Evaluation of Its Prognostic Value

Cited by 74 publications

References 5 publications

Fertility after Neosalpingostomy through Laparoscopic Way in Point “G” Teaching Hospital

Fertility after Neosalpingostomy through Laparoscopic Way in Point “G” Teaching Hospital

Nanofiber Hydrogel Drug Delivery System for Prevention of Postsurgical Intestinal Adhesion

Thixotropic β-Chitin Nanofiber Hydrogel with a Living Body-Responsive Self-Hardening Property and Its Application as a Sprayable Antiadhesion Barrier

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