Intraperitoneal adhesions: pathogenesis, clinical significance, and prevention strategies

Kocaay, Akın Fırat; Çelik, Süleyman Utku; Eker, Tevfik; Çetinkaya, Ömer Arda; Genç, Volkan

doi:10.5350/semb.20151022054044

Cited by 5 publications

(8 citation statements)

References 19 publications

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“…Abdominal bölgede bir süre çözülmeden kalabilecek şekilde tasarlanmış ve hasarlanmış serozal yüzeyler arasında ve serozanın paryetal peritonla etkileşimini engelleyen ajanlardır. Mekanik bariyerler; hem laparoskopik hem de açık operasyonlarda kolay kullanımlı, güvenli, anti-inflamatuvar, enfeksiyonu desteklemeyen, yapışıklıklara neden olmayan ve iyileşmeyi engellemeyen bir yapıda, sütür olmadan yerinde kalabilecek şekilde tasarlanmış, kanamalı alanda aktif kalabilen özellikte, serozal reepitelizasyon için gerekli olan 5-7 günlük süre boyunca periton içerisinde kalıp peritoneal iyileşmeyi takiben absorbe olabilmesi gibi temel tanımlamalara uygun olmalıdır 49 .…”

Section: Mekanik Bariyerlerunclassified

“…Ciddi yan etkileri nedeni ile daha önceki dönemde sık kullanılan hipertonik solüsyon ise %32 dekstran 70 çözeltisinin kullanımı artık tercih edilmemektedir. Sıvı bariyerlerden hiyaluronik asit ve ikodekstrin'in karın boşluğunda uzun süre emilmeden kalabilmeleri onları çalışmalarda sıklıkla tercih edilen ajanlar haline getirmiştir 49 .…”

Section: Mekanik Bariyerlerunclassified

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Histopathological Overview of Intrabdominal Adhesion Formation Mechanisms and Treatment Strategies

EROĞLU>

Uyanıkgil

2022

Arşiv Kaynak Tarama Dergisi

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Hayat standartlarını olumsuz etkileyen abdominal adezyonlar, postoperatif dönemde görülen önemli bir sağlık sorunudur. Peritoneal kavite ve serozal yüzeylerde oluşan, abdominal travmalara sebep olan kimyasal ve termal faktörler ya da enfeksiyon ve yabancı cisim reaksiyonları adezyon oluşumuna sebep olabilir. Abdominal adezyonların sınıflandırması genellikle adezyon yoğunluğuna ve prognoz ciddiyetine göre yapılsa da henüz dünya çapında kabul görmüş standart bir sınıflandırma sistemi mevcut değildir. Abdominal adezyonlar ağrı, infertilite, cerrahi sonrası hastanede yatış süresinin uzaması ve ekonomik yük gibi olumsuz sonuçlarla klinik yansımalar gösterir. Sonuç olarak, postoperatif süreçte karşılaşılan adezyonlar ciddi bir sorundur ve adezyon oluşumunu engellemek için ileri çalışmaların laboratuvar ortamından klinik araştırma modellerine uyarlanması gerekmektedir. Bu derleme çalışması intraabdominal adezyon oluşumu, histopatolojisi, derecelendirilmesi, önlenmesi ve klinik önemi ile ilgili literatürü gözden geçirmek için hazırlanmıştır.

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Section: Mekanik Bariyerlerunclassified

Histopathological Overview of Intrabdominal Adhesion Formation Mechanisms and Treatment Strategies

EROĞLU>

Uyanıkgil

2022

Arşiv Kaynak Tarama Dergisi

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“…We know that adhesions secondary to previous abdominal surgery account for approximately 75% of small intestinal obstructions. In addition, we encounter with a considerable amount of hernias, congenital anomalies, and carcinomatosis due to intra-abdominal tumors [7,8].…”

Section: Extrinsic Factorsmentioning

confidence: 99%

“…According to the mechanism of formation, there are also paralytic ileus, spastic ileus, and chronic intestinal pseudo-obstruction as well as mechanical intestinal obstruction. While paralytic ileus can be observed as a result of insufficient nerve conduction due to excessive analgesic use or electrolyte imbalance, spastic ileus occurs in cases of increased nerve conduction, such as metal poisoning [2,[7][8][9].…”

Section: Extrinsic Factorsmentioning

confidence: 99%

Surgical Recovery of Intestinal Obstructions: Pre- and Postoperative Care and How Could it Be Prevented?

Kanat¹,

Eröz²,

Saçli³

et al. 2020

Surgical Recovery

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Although initial data on intestinal obstructions are based on Hippocrates, there is still no consensus on approaches today. However, parallel to the development of medical technology and the increasing experience of us surgeons, morbidity and mortality rates due to intestinal obstruction have decreased. Obstruction can occur at any point in the gastrointestinal tract. The main thing is to make a correct diagnosis and to treat the patient in the most correct way. Intestinal obstructions usually present with colic abdominal pain, nausea, vomiting, and constipation. Intestinal obstructions may be present due to various reasons. Surgeons have an important role in preventive mechanical obstructions due to adhesions. Patients must be hospitalized. If there is no emergency surgical indication, conservative methods can be applied. Patients should be mobilized early, and fluid-electrolyte balance should be adjusted and followed closely.

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“…Ischemia and foreign body enhance the improvement of adhesions. The most vital factors to reduce adhesions are introduction of minimum surgical trauma, reducing trauma to the peritoneum, minimizing preliminary damage, medical interventions within the fibrin formation/ degradation balance, avoiding coagulation of exudate, reducing contact times of tissues and organs with each other through barriers, stopping or slowing fibroblast proliferation (Perko et al 2011, Leblebici et al 2014, Karabulut and Canpolat 2016, Kocaay et al 2015. Fibrinolytic agents used to prevent adhesions during surgical interventions should not be preferred as they may increase bleeding.…”

Section: Figures In Parenthesis Indicatementioning

confidence: 99%

Effectiveness of polypropylene mesh coated bovine amniotic membrane with adhesion barrier (polyethylene glycol) in repair of abdominal wall hernias in rats

Rashid

Karabulut²,

Çevik

2018

Indian J of Anim Sci

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This study was undertaken to investigate the effectiveness of polypropylene (PP) mesh coated bovine amniotic membrane (BAM) with 5% polyethylene glycol (PEG) 4000 as adhesion barrier in the repair of experimental 2 × 2 cm of abdominal hernias in rats. Rats (32) were divided into 4 groups. A 2 cm × 2 cm defect was created in the full thickness of abdominal muscle on the anterior abdominal wall. PP mesh was implanted in the abdominal cavity (Gr 1 to 4). BAM covered the abdominal face of the graft (Gr 3 and 4). It was given before the abdominal closure 5 ml of 5% PEG 4000 (Gr 2 and 4) and 5 ml of 0.9% NaCl (Gr 1 and 3). After 21 days following the operations, 32 rats were euthanized. Macroscopic and microscopic evaluations were performed according to the scoring systems. The differences between the groups was evaluated by Mann-Whitney U test and Kruskal Wallis analysis of variance. Highest adhesion percentage was observed in Gr 1 and lowest in Gr 4. Inflammatory reaction was observed in Gr 1 and 2. According to the results of this study, the combined use of BAM and 5% PEG 4000 was helpful to prevent the complications of PP mesh.

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Intraperitoneal adhesions: pathogenesis, clinical significance, and prevention strategies

Cited by 5 publications

References 19 publications

Histopathological Overview of Intrabdominal Adhesion Formation Mechanisms and Treatment Strategies

Histopathological Overview of Intrabdominal Adhesion Formation Mechanisms and Treatment Strategies

Surgical Recovery of Intestinal Obstructions: Pre- and Postoperative Care and How Could it Be Prevented?

Effectiveness of polypropylene mesh coated bovine amniotic membrane with adhesion barrier (polyethylene glycol) in repair of abdominal wall hernias in rats

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