Intra-abdominal adhesions: Anatomy, physiology, pathophysiology, and treatment

Beyene, Robel; Kavalukas, Sandra L.; Barbul, Adrian

doi:10.1067/j.cpsurg.2015.05.001

Cited by 102 publications

(95 citation statements)

References 296 publications

(170 reference statements)

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“…include the adhesive small bowel obstruction, which is the one of the most common causes of mechanical intestinal obstruction of nononcological origin (Beyene, Kavalukas, & Barbul, 2015). One of the main causes of infertility in women is adhesions between the pelvic organs (Brüggmann et al, 2010).…”

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confidence: 99%

Fabrication and characterization of pectin‐based three‐dimensional porous scaffolds suitable for treatment of peritoneal adhesions

Kulikouskaya

Kraskouski

Hileuskaya

et al. 2019

J Biomedical Materials Res

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Formation of peritoneal adhesions is common complication after abdominal and pelvic surgery. They bear a significant health problem with an influence to quality of life and health care expenses. Promising approach for their prevention is using of biodegradable barrier films for physical separation of peritoneal surfaces. In the present study, highly porous pectin‐based three‐dimensional (3D) scaffolds were obtained by freeze‐drying technique. Physico‐chemical properties of the formed materials, including their morphology, porosity, density, and stability, have been studied. The evaluation of their biocompatibility, biodegradation, and potential antiadhesion effect was studied by in vivo experiment. To reinforce the scaffolds structure and improve their stability in physiological solutions, pectin chains were cross‐linked with divalent cations. We determined optimal cross‐linking conditions, which allow obtaining scaffolds with desired biodegradation rate. These cross‐linked scaffolds fully dissolved within 8 days in the peritoneal cavity with low presence of complications and some antiadhesive effect. It has also been determined that mesenchymal stem cells from adipose tissue could effectively adhere to the scaffolds with preservation of their viability. Our results show that obtained materials can be suggested as mechanical scaffold for delivery of the stem cells culture to peritoneal surfaces as a part of complex antiadhesive barrier system.

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mentioning

confidence: 99%

Fabrication and characterization of pectin‐based three‐dimensional porous scaffolds suitable for treatment of peritoneal adhesions

Kulikouskaya

Kraskouski

Hileuskaya

et al. 2019

J Biomedical Materials Res

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“…These unavoidable postoperative adhesions can cause a series of clinical problems such as intestinal obstruction, postoperative abdominal and pelvic pain, female infertility, and difficult access in a subsequent surgery [2,3]. Intra-abdominal adhesion formation is caused by fibrin exudation and deposition due to inflammation in the injured peritoneum; concurrently, a decreased ability to dissolve fibrin at the injured sites can also lead to adhesion formation [4]. Therefore, at present, the following preventive strategies against postoperative intraabdominal adhesions should be considered: (l) minimize the surgical trauma; (2) reduce the inflammatory reaction; and (3) reduce the fibrin exudation and promote its absorption.…”

Section: Introductionmentioning

confidence: 99%

Effect of Resveratrol on the Prevention of Intra-Abdominal Adhesion Formation in a Rat Model

Wei

Chen

Wang

et al. 2016

Cell Physiol Biochem

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Background: Intra-abdominal adhesions are a very common complication following abdominal surgery. Our previous studies have demonstrated that the inhibition of inflammation at the sites of peritoneal injury can prevent the formation of intra-abdominal adhesions. Resveratrol is a natural extract with a broad range of anti-inflammatory effects. Therefore, we propose that resveratrol can reduce the formation of intra-abdominal adhesions after surgery. The aim of this study was to investigate the effect of resveratrol on intra-abdominal adhesion prevention in a rat model with surgery-induced peritoneal adhesions. Materials and Methods: The cecum wall and its opposite parietal peritoneum were abraded following laparotomy to induce intra-abdominal adhesion formation. Varying doses of resveratrol were administered to the animals. On the eighth day after surgery, the adhesion score was assessed using a visual scoring system. Picrosirius red staining and a hydroxyproline assay were used to assess the amount of collagen deposition in the adhesion tissues. The levels of serum interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and transforming growth factor beta-1 (TGF-β1) were determined by an enzyme-linked immunosorbent assay (ELISA). Western blotting was performed to determine the protein expression of TGF-β1, fibrinogen, and α-smooth muscle actin (α-SMA) in rat peritoneal adhesion tissue. Real-time RT-PCR was performed to quantify the mRNA expression of TGF-β1, fibrinogen, and α-SMA. Results: Resveratrol significantly reduced intra-abdominal adhesion formation and fibrin deposition in the rat model. Furthermore, resveratrol significantly reduced the serum levels of IL-6, TNF-α, and TGF-β1. The protein and mRNA expression of TGF-β1, fibrinogen, and α-SMA in the rat peritoneum and adhesion tissues were also down-regulated due to resveratrol intervention. Conclusion: Resveratrol can effectively prevent the formation of postoperative intra-abdominal adhesions in a rat model. This effect may be related to the suppression of inflammatory cytokine expression in the injured peritoneum by resveratrol. This study suggests that resveratrol may be a new and effective anti-adhesive agent that is worthy of further study and has potential application value.

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“…A multifactorial approach including gentle handling, maintaining abdominal organs moist, sterility and peritoneal closure is needed to reduce adhesion formation following surgery in rabbits (Whitfield and others 2007, Szabo and others 2016). The authors have no experience with adhesion barrier usage but suggest this may be considered in future cases (Lang and others 2007, Beyene and others 2015). In retrospect, the presumed steatitis noted on surgical excision may have predisposed to adhesion formation in this rabbit.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic challenges and surgical treatment of hydroureteronephrosis in a rabbit (Oryctolagus cuniculus)

Tahas

Pope

Denk³

et al. 2017

Vet Record Case Reports

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A two-and-half-year-old male neutered rabbit was referred for investigation of intermittent urinary disease of 13 months in duration. Case work-up led to the diagnosis of unilateral hydroureteronephrosis following obstructive ureterolithiasis. The establishment of contralateral kidney function before ureteronephrectomy constituted a particular diagnostic challenge. This was assessed by a combination of imaging, serum biochemistry, urine protein to creatinine ratio and γ-glutamyltransferase index. Ureteronephrectomy was subsequently performed, with initial remission of all clinical signs. However, an adhesion of mesenteric adipose tissue to the caecum was identified and resected following frequent re-presentation. At the time of submission (800 days following initial surgery), the rabbit was still alive and healthy. The successful outcome may indicate a more favourable prognosis for rabbits with unilateral ureteronephrolithiasis and/or hydroureteronephrosis than is historically proposed.

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Intra-abdominal adhesions: Anatomy, physiology, pathophysiology, and treatment

Cited by 102 publications

References 296 publications

Fabrication and characterization of pectin‐based three‐dimensional porous scaffolds suitable for treatment of peritoneal adhesions

Fabrication and characterization of pectin‐based three‐dimensional porous scaffolds suitable for treatment of peritoneal adhesions

Effect of Resveratrol on the Prevention of Intra-Abdominal Adhesion Formation in a Rat Model

Diagnostic challenges and surgical treatment of hydroureteronephrosis in a rabbit (Oryctolagus cuniculus)

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