Lipid emulsions prevent postoperative abdominal adhesions

Sirovy, Miroslav; Krupova, Marketa; Hyspler, R.; Tichá, Alena; Koláčková, Martina; Andrýs, Ctirad; Radochová, Věra; Astapenko, David; Odlozilova, Sarka; Kotek, Jiří; Zajak, J; Paral, Jiri

doi:10.1016/j.asjsur.2022.05.119

Cited by 8 publications

(3 citation statements)

References 38 publications

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“…Adhesions are significantly less common after laparoscopic surgery compared to open surgery, though not completely eliminated. However, the likelihood of postoperative hernias, including internal hernias, is higher in laparoscopic colorectal surgery [ 18 , 19 ]. Incisional hernias are also more frequent in single-port laparoscopic gynecological surgery [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

A novel technique for NO.253 lymph node dissection and left colic artery preservation to avoid potential postoperative internal hernia in laparoscopic radical resection for rectal cancer

Luo,

Li,

Qian

et al. 2024

BMC Surg

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Background The preservation of the left colic artery (LCA) has emerged as a preferred approach in laparoscopic radical resection for rectal cancer. However, preserving the LCA while simultaneously dissecting the NO.253 lymph node can create a mesenteric defect between the inferior mesenteric artery (IMA), the LCA, and the inferior mesenteric vein (IMV). This defect could act as a potential “hernia ring,” increasing the risk of developing an internal hernia after surgery. The objective of this study was to introduce a novel technique designed to mitigate the risk of internal hernia by filling mesenteric defects with autologous tissue. Methods This new technique was performed on eighteen patients with rectal cancer between January 2022 and June 2022. First of all, dissected the lymphatic fatty tissue on the main trunk of IMA from its origin until the LCA and sigmoid artery (SA) or superior rectal artery (SRA) were exposed and then NO.253 lymph node was dissected between the IMA, LCA and IMV. Next, the SRA or SRA and IMV were sequentially ligated and cut off at an appropriate location away from the “hernia ring” to preserve the connective tissue between the “hernia ring” and retroperitoneum. Finally, after mobilization of distal sigmoid, on the lateral side of IMV, the descending colon was mobilized cephalad. Patients’preoperative baseline characteristics and intraoperative, postoperative complications were examined. Results All patients’ potential “hernia rings” were closed successfully with our new technique. The median operative time was 195 min, and the median intraoperative blood loss was 55 ml (interquartile range 30–90). The total harvested lymph nodes was 13.0(range12−19). The median times to first flatus and liquid diet intake were both 3.0 days. The median number of postoperative hospital days was 8.0 days. One patient had an injury to marginal arterial arch, and after mobolization of splenic region, tension-free anastomosis was achieved. No other severe postoperative complications such as abdominal infection, anastomotic leakage, or bleeding were observed. Conclusions This technique is both safe and effective for filling the mesenteric defect, potentially reducing the risk of internal hernia following laparoscopic NO.253 lymph node dissection and preservation of the left colic artery in rectal cancer surgeries.

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Section: Discussionmentioning

confidence: 99%

A novel technique for NO.253 lymph node dissection and left colic artery preservation to avoid potential postoperative internal hernia in laparoscopic radical resection for rectal cancer

Luo,

Li,

Qian

et al. 2024

BMC Surg

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“…[ 2 ] PIAAs can lead to complications such as ileus, infarction, fistulas, chronic pelvic pain, infertility, and may present technical challenges in subsequent surgeries. [ 3 , 4 ]…”

Section: Introductionmentioning

confidence: 99%

“…Despite trials of various surgical techniques and adjuvants, such as barrier agents or drugs, to prevent PIAA, no ideal method has emerged that both protects mesothelial cells and minimizes surgical damage while ensuring hemostasis. [ 3 , 7 ] Although some adjuvants have shown potential in experimental studies due to their anti-inflammatory or fibrinolytic effects, consensus on their effectiveness and safety has not been reached, and their application is limited to the specific expertise of the practitioner. [ 5 ]…”

Section: Introductionmentioning

confidence: 99%

Effects of pioglitazone and metformin on abdominal adhesion formation in an experimental model

Yücesoy

2024

Ulus Travma Acil Cerrahi Derg

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Evaluation of the effect of Dracocephalum kotschyi hydroalcoholic extract in preventing intra-abdominal adhesions after abdominal surgery in rats based on inflammatory factors (TNF-α and IL-1β)

Rezvan,

Saghaei

2024

Comp Clin Pathol

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Lipid emulsions prevent postoperative abdominal adhesions

Cited by 8 publications

References 38 publications

A novel technique for NO.253 lymph node dissection and left colic artery preservation to avoid potential postoperative internal hernia in laparoscopic radical resection for rectal cancer

A novel technique for NO.253 lymph node dissection and left colic artery preservation to avoid potential postoperative internal hernia in laparoscopic radical resection for rectal cancer

Effects of pioglitazone and metformin on abdominal adhesion formation in an experimental model

Evaluation of the effect of Dracocephalum kotschyi hydroalcoholic extract in preventing intra-abdominal adhesions after abdominal surgery in rats based on inflammatory factors (TNF-α and IL-1β)

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