Peritoneale Adhäsionsbildung

Hong, Guanghui; Vilz, Tim O.; Kalff, Joerg C.; Wehner, Sven

doi:10.1007/s00104-014-2975-8

Cited by 12 publications

(11 citation statements)

References 27 publications

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“…Many attempts have been made to solve this burden. The pharmacological approach is still in the experimental stage 9 . A number of medical devices acting as temporary mechanical barriers have been introduced into clinical practise, but none of those has been completely satisfying 6 , 12 - 14 .…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the Effectiveness of Peritoneal Adhesion Prevention Devices in a Rat Model

Poehnert¹,

Grethe²,

Maegel³

et al. 2016

Int. J. Med. Sci.

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Background: Abdominal operations are followed by adhesions, a prevalent cause of abdominal pain, and the most frequent cause for bowel obstruction and secondary female infertility. This rat study addresses adhesion prevention capability of Adept®, Interceed®, Seprafilm®, and a novel device, 4DryField® PH which is provided as powder and generates its effect as gel.Methods: Sixty-eight male Lewis rats had cecal abrasion and creation of an equally sized abdominal wall defect, and were grouped randomly: A control group without treatment (n=10); two groups treated with 4DryField® PH using premixed gel (n=15) or in-situ gel technique (n=16); one group each was treated with Seprafilm® (n=8), Interceed® (n=9), or Adept® (n=10). Sacrifice was on day 7 to evaluate incidence, quality, and quantity of adhesions, as expressed via adhesion reduction rate (AR). Histologic specimens were evaluated. Statistical analyses used ANOVA and unpaired t-tests.Results: 4DryField® PH significantly reduced incidence and severity of adhesions both as premixed gel (AR: 85.2%) and as in-situ made gel (AR: 100%), a comparison between these two application techniques showed no differences in efficacy. Seprafilm® did not reduce incidence but severity of adhesions significantly (AR: 53.5%). With Interceed® (AR: 3.7%) and Adept® (AR: 16.1%) no significant adhesion-reduction was achieved. Except for inflammatory response with Interceed®, histopathology showed good tissue compatibility of all other devices.Conclusion: 4DryField® PH and Seprafilm® showed significant adhesion prevention capabilities. 4DryField® PH achieved the highest adhesion prevention effectiveness without restrictions concerning mode of application and compatibility and, thus, is a promising strategy to prevent abdominal adhesions.

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Section: Discussionmentioning

confidence: 99%

“…Pharmacological agents are still in an experimental stage and are not yet available in surgical practice. Additionally, they bear the disadvantage of involving the whole metabolism of individuals 9 .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Effectiveness of Peritoneal Adhesion Prevention Devices in a Rat Model

Poehnert¹,

Grethe²,

Maegel³

et al. 2016

Int. J. Med. Sci.

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“…Adhesions, as found in our study, are an important factor contributing to secondary infertility and are also supported by the literature. 10 Systematic review of Chocrane database 2009 have shown that adhesiolysis and restoration of Tubal anatomy help improve outcomes in cases of Infertility. 11 Endometriosis per se, as well as surgical resection of bowel for prior endometriosis, can lead to bowel adhesions and increased risk of secondary infertility.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopy in Infertility: A Retrospective Analysis of 200 Cases

Pathak¹

2018

Journal of South Asian Federation of Obstetrics and Gynaecology

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Study objective:The aim of this study is to analyze the findings in females on whom laparoscopy was performed for the evaluation and management of infertility.Design: Retrospective study in a Multispecialty Hospital.Participants: Two hundred patients who underwent diagnostic and Operative Laparoscopy for evaluation and management of infertility in the age group 20-49 years were selected. Materials and methods:In this retrospective observational study we evaluated 200 patients on whom laparoscopy was performed for evaluation of primary or secondary infertility, and simultaneous management of the cause was done in a gynae-endoscopy unit in Delhi. The study included 120 females of primary Infertility and 80 women with secondary Infertility for 18 months. Laparoscopic findings, patient's age, nature of pathology and their distribution, the most common factor involved in infertility, chromopertubation, and results were analyzed from the data collected from these available case records.Results: Total 200 women on whom laparoscopy was performed for evaluation of infertility, it was observed that there were 120 cases were of primary infertility, Out of 120, 8 cases had no abnormal finding. A most common finding was endometriosis in 6/120 (57.5%) cases including endometrioma in 38 (31.7%) cases. Tubal factor 24 cases (20%), ovarian factor 14 cases (11.7%), bowel and Omental adhesions28 cases (23.33%), PCOD 32 cases (26.7%), and myoma 34 cases (28.33%), similarly Out of 80 cases of secondary infertility in 11 cases no abnormal finding was there. Strangely, even in cases of secondary infertility, we found endometriosis to be the most common cause in about 53/80 (66.3%) cases which is a significant number. This may be the possible reason for adhesions (Bowel, mental and other) also which account to42 cases (52.5%). Tubal factor 13 cases (16.25), ovarian factor 9 cases (11.25%), endometriosis 24 cases (30%), PCOD 4 cases (5%), Myoma17 cases (21.25%).In both primary and secondary infertility, filmy dense adhesions were seen distorting the normal anatomy. These findings were not significant according to age groups 20-30 years and >30 years. Conclusion:In this study, endometriosis was found to be the most significant factor contributing to both primary and secondary infertility and also giving an explanation to increased finding Bowel/Omental and pelvic adhesions. Sometimes, more than one factor is present in overlapping fashion making management more difficult. Laparoscopy has a key role in delineating and managing such cases. It is the minimally invasive method, reaching new horizons with better technique. Simultaneous chromopertubation can be done for evaluation of tubal patency. Now in this era, it is impossible to consider workup for infertility without the aid of laparoscopy.Clinical significance: This study demonstrates the benefits of laparoscopy in the evaluation of infertility patients and the advantages of the minimally invasive technique. Statistical analysis:Fischer's exact test for calculation of p value. A p value...

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“…Postoperative adhesions occur at a high rate after surgery, and their adverse effects are widely recognized as peritoneal adhesions after abdominal surgery, which are known to cause organ disorders such as abdominal pain, ileus, and infertility 1 , 2 . Moreover, such postoperative adhesions after abdominal surgery are known to occur after endoscopic surgery, as well as after laparotomy 3 .…”

Section: Introductionmentioning

confidence: 99%

Development of an Anti-Adhesive Membrane for Use in Video-Assisted Thoracic Surgery

et al. 2018

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Background: The need to prevent postoperative adhesions after surgery has been considered a significant challenge in thoracic surgery, especially with the advent of video-assisted thoracic surgery (VATS). While preventive materials for postoperative adhesions have been studied for many years, they are all still in the development phases.Methods: In this animal study, an insoluble hyaluronic acid membrane was used in VATS for wedge resection to test its operability and to examine the body's response to the membrane. Ten beagles were divided into two groups, an experimental group and a negative control group. In the experimental group, an insoluble hyaluronic acid membrane containing glycerol was used as the test membrane (10 x 10 x 0.1 cm3). The test membrane was implanted in the left thoracic cavity of the animal under VATS following wedge resection. The animals were observed for two weeks and then euthanized for examination.Results: Macroscopically, the median adhesion score was lower in the experimental group (0) than in the control group (2.5). On histopathological examination, the test membrane elicited only a minor inflammatory response and foreign body reaction.Conclusion: The test membrane showed satisfactory operability and appears to be a practical material to prevent postoperative adhesions after thoracic surgery in VATS.

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Peritoneale Adhäsionsbildung

Cited by 12 publications

References 27 publications

Evaluation of the Effectiveness of Peritoneal Adhesion Prevention Devices in a Rat Model

Evaluation of the Effectiveness of Peritoneal Adhesion Prevention Devices in a Rat Model

Laparoscopy in Infertility: A Retrospective Analysis of 200 Cases

Development of an Anti-Adhesive Membrane for Use in Video-Assisted Thoracic Surgery

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