334 results
Search Results
2. Diagnosis and management of small bowel obstruction in virgin abdomen: a WSES position paper
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Yousef Amara, Ari Leppaniemi, Fausto Catena, Luca Ansaloni, Michael Sugrue, Gustavo P. Fraga, Federico Coccolini, Walter L. Biffl, Andrew B. Peitzman, Yoram Kluger, Massimo Sartelli, Ernest E. Moore, Salomone Di Saverio, Esfo Darwish, Chikako Endo, Harry van Goor, and Richard P. ten Broek
- Subjects
Small bowel obstruction ,Virgin abdomen ,Adhesions ,Conservative management ,operative management ,Immediate intervention ,Surgery ,RD1-811 ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background Small bowel obstruction (SBO) is a common surgical emergency, causing high morbidity and healthcare costs. The majority of SBOs are caused by adhesions that result from previous surgeries. Bowel obstruction, however, also occurs in patients without previous operation or known pathology, a so called virgin abdomen. It is unknown if small bowel obstruction in the virgin abdomen (SBO-VA) can be managed according to the same principles as other cases of small bowel obstruction. The aim of this position paper is to evaluate the available evidence on etiology and management of small bowel obstruction in the virgin abdomen. Methods This is a narrative review with scoping aspects. Clinical topics covered in this review include epidemiology and etiology of SBO-VA, diagnosis and imaging, initial assessment, the role of surgical management in SBO-VA, and the role of non-operative management in SBO-VA. Results Our scoping search revealed seven original studies reporting original patient data related to SBO-VA. All the included studies are retrospective cohorts, with populations ranging between 44 and 103 patients with SBO-VA. Adhesions were found to be the cause of the obstruction in approximately half of the reported cases of SBO-VA. A relatively high number of cases of SBO-VA were managed surgically with studies reporting 39–83%. However, in cases where a trial of non-operative management was started, this was generally successful. Conclusion The data available suggest that etiology and treatment results for patients with SBO-VA are largely comparable to the results in patients with SBO after previous abdominal surgery. We therefore propose that patients with a virgin abdomen could be treated according to existing guidelines for SBO and adhesive small bowel obstruction.
- Published
- 2021
- Full Text
- View/download PDF
3. Diagnosis and management of small bowel obstruction in virgin abdomen: a WSES position paper
- Author
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Walter L. Biffl, Luca Ansaloni, Salomone Di Saverio, Yousef Amara, Fausto Catena, Chikako Endo, Massimo Sartelli, Harry van Goor, Michael Sugrue, Gustavo Pereira Fraga, Federico Coccolini, Ari Leppäniemi, Esfo Darwish, Richard P. G. ten Broek, Andrew B. Peitzman, Yoram Kluger, and Ernest E. Moore
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medicine.medical_specialty ,RD1-811 ,Adhesions ,medicine.medical_treatment ,Review ,Virgin abdomen ,03 medical and health sciences ,0302 clinical medicine ,Conservative management ,Immediate intervention ,operative management ,Small bowel obstruction ,Laparotomy ,Intestine, Small ,Epidemiology ,medicine ,Humans ,Surgical emergency ,RC86-88.9 ,business.industry ,General surgery ,Medical emergencies. Critical care. Intensive care. First aid ,medicine.disease ,3. Good health ,Review article ,Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] ,Bowel obstruction ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Emergency Medicine ,Etiology ,Abdomen ,030211 gastroenterology & hepatology ,Surgery ,business ,Intestinal Obstruction ,Abdominal surgery - Abstract
BackgroundSmall bowel obstruction (SBO) is a common surgical emergency, causing high morbidity and healthcare costs. The majority of SBOs are caused by adhesions that result from previous surgeries. Bowel obstruction, however, also occurs in patients without previous operation or known pathology, a so called virgin abdomen. It is unknown if small bowel obstruction in the virgin abdomen (SBO-VA) can be managed according to the same principles as other cases of small bowel obstruction. The aim of this position paper is to evaluate the available evidence on etiology and management of small bowel obstruction in the virgin abdomen.MethodsThis is a narrative review with scoping aspects. Clinical topics covered in this review include epidemiology and etiology of SBO-VA, diagnosis and imaging, initial assessment, the role of surgical management in SBO-VA, and the role of non-operative management in SBO-VA.ResultsOur scoping search revealed seven original studies reporting original patient data related to SBO-VA. All the included studies are retrospective cohorts, with populations ranging between 44 and 103 patients with SBO-VA. Adhesions were found to be the cause of the obstruction in approximately half of the reported cases of SBO-VA. A relatively high number of cases of SBO-VA were managed surgically with studies reporting 39–83%. However, in cases where a trial of non-operative management was started, this was generally successful.ConclusionThe data available suggest that etiology and treatment results for patients with SBO-VA are largely comparable to the results in patients with SBO after previous abdominal surgery. We therefore propose that patients with a virgin abdomen could be treated according to existing guidelines for SBO and adhesive small bowel obstruction.
- Published
- 2021
4. Outcomes and Complications After Repeat Cesarean Sections Among King Abdulaziz University Hospital Patients
- Author
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Motaz K. Alshuaibi, Ayman Oraif, Meshal A. Aldhubabian, Khalid A Alshehri, Mohammed S. Al-Zanbaqi, Ahmed A. Ammar, and Ahyad A. Felimban
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Pregnancy ,medicine.medical_specialty ,Original Paper ,Obstetrics ,business.industry ,multiple Cesarean sections ,complication ,adhesions ,University hospital ,medicine.disease ,Intraoperative bleeding ,surgical procedures, operative ,medicine ,otorhinolaryngologic diseases ,outcome ,Cesarean delivery ,Complication ,business - Abstract
Introduction: Cesarean section (CS) is a surgical procedure that often saves the lives of both the mother and the baby, while a previous CS is one of the main indications for cesarean delivery in current pregnancy. Aim: Our aim was to determine the surgical and obstetrical outcomes and complication for the mother and the neonate after 4 or more CSs and compare it with mothers who had less than 4 previous CSs. Methods: This case-control study was conducted by reviewing the records of all women who underwent multiple CSs from 2013 to 2018. Our study group comprised of 394 women who had 4 or more CSs, and our control group comprised of similar number of women who had previous history of two or three CSs. Results: A total of 788 patients were enrolled in our study. We found that adhesions were the most common complications in our study group with a considerable increase in number of both moderate and severe adhesions in the study group compared to the controls with p-value of
- Published
- 2019
5. The Association of Appendectomy, Adhesions, Tubal Pathology, and Female Infertility
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Oliver J. Muensterer, Rudolf Seufert, Saskia Silver, and Victoria Margaux Becker
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Adult ,050101 languages & linguistics ,medicine.medical_specialty ,media_common.quotation_subject ,Adhesions ,Population ,Fertility ,Diagnostic laparoscopy ,Tissue Adhesions ,Scientific Paper ,050105 experimental psychology ,Cohort Studies ,medicine ,Appendectomy ,Humans ,0501 psychology and cognitive sciences ,University medical ,Female infertility ,education ,media_common ,Retrospective Studies ,education.field_of_study ,business.industry ,General surgery ,05 social sciences ,Tubal pathology ,Fallopian Tube Diseases ,medicine.disease ,Appendicitis ,Tube pathology ,Cohort ,Surgery ,Female ,Laparoscopy ,business ,Infertility, Female - Abstract
Background and Objectives: The aim of the study was to investigate a potential association between previous childhood appendectomy, tube pathology, and female infertility. Methods: We reviewed patients seeking care at the fertility clinic of our university medical center between 2006 and 2016. The history of previous appendectomy was extracted from hospital documentation and by telephone follow-up. Tubal patency was assessed by diagnostic laparoscopy and chromopertubation. Results: In our study cohort (N = 237), 24.9% (n = 59) had a history of previous appendectomy. Previous appendectomy, therefore, was about 3-fold more prevalent in women seeking fertility treatment than in the general population. Patients with previous appendectomy had more intra-abdominal adhesions (P < .001) and patients with adhesions tended to have compromised tubal patency (P = .05). However, there was no direct correlation between a previous appendectomy and tube pathology (P = .727). Conclusion: Because previous appendectomy was associated with intra-abdominal adhesions, and these were in turn associated with tube pathology, but appendectomy was not directly associated with compromised tubal patency, previous appendectomy may indirectly affect female fertility through mechanisms other than direct tubal obstruction. This is one of the largest study analyzing laparoscopic chromopertubation in association with previous childhood appendectomy.
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- 2019
6. Wedge-shape Merocel Pack After Functional Endoscopic Sinus Surgery: Our Experience With 697 Patients
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Haitham Odat, Wisam Al-Gargaz, and Mohannad Al-Qudah
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Adult ,medicine.medical_specialty ,Rhinosinusitis ,Chronic rhinosinusitis ,Adhesions ,Endoscopic sinus surgery ,Postoperative Hemorrhage ,Middle meatus ,Formaldehyde ,medicine ,Humans ,Nasal polyps ,Retrospective Studies ,Rhinitis ,Asthma ,Medical treatment ,business.industry ,Bleeding ,Professional Paper ,General Medicine ,Functional endoscopic sinus surgery ,medicine.disease ,Surgery ,Polyvinyl Alcohol ,Pack ,Wedge shape ,business ,Major bleeding - Abstract
Background: Chronic rhinosinusitis (CRS) is a disease characterized by inflammation of the paranasal sinus mucosa for a duration of more than 12 weeks. It is one of the most frequently diagnosed chronic diseases that is encountered in everyday practice with an overall prevalence ranges from 7% to 27% Objective: To evaluate our long-term experience using wedge-shape middle meatal Merocel packing after functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis (CRS). Methods: charts and electronic records of consecutive adult CRS patients who failed to respond to medical treatment and underwent endoscopic sinus surgery using wedge-shaped middle meatal Merocele packing were retrospectively reviewed. Demographic data, presence and absence of nasal polyps and/or asthma, postoperative bleeding, middle meatal adhesions and/or lateralization, and requirement of adhesiolysis were reviewed. Results: 697 patients (1394 nasal sides) were included. The mean age was 34 years. CRS with nasal polyps was observed in 224 patients (32%) and 185 (27%) had associated asthma. Postoperative pain and discomfort while the pack in place were tolerable and no patient required pre-scheduled pack removal. All packs were removed in the clinic with tolerable discomfort. No major bleeding that required re-packing was seen, but mild oozing or minor bleeding was encountered in some cases which was controlled by small cotton packs soaked with diluted adrenaline. Thirty-four patients (4.9%) had middle meatal adhesions. Right side adhesions were seen in 13 patients (38.2%), left side adhesions in 12 patients (35.3%), and bilateral in 9 patients (26.4%). Significant severe lateralized middle turbinate was observed in 2 cases. No infectious complications related to the pack have happened. Conclusion: Wedge-shaped Merocel pack is an effective middle meatal pack after FESS. It is easy to shape, widely available, and economical. It can decrease early postoperative bleeding and also it provides support to the middle turbinate preventing lateralization and adhesions.
- Published
- 2021
7. Pre-operative Decision Making in Adhesive Small Bowel Obstructions
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Terzian, W. T. Hillman and Carmichael, Samuel P.
- Published
- 2024
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8. Prospective mixed-methods study of patients undergoing relaparotomy (ReLap study; DRKS00013001)
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Dinh Thien-An, Tran, Colette, Doerr-Harim, Felix J, Hüttner, Julian C, Harnoss, Phillip, Knebel, Martin, Schneider, Markus W, Büchler, Markus K, Diener, and Pascal, Probst
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POD, Postoperative day ,Adhesions ,Abdominal surgery ,Fascial closure ,SDGC, Study Center of the German Surgical Society ,Relaparotomy ,Research Paper - Abstract
Highlights • Patients undergoing relaparotomies are underrepresented in clinical trials. • The study has three steps: health care research, translational research, and RCT. • The clinical course will be followed prospectively. • Main outcomes are postoperative complications, incisional hernias and adhesions. • The ReLap study will gain evidence for best care in relaparotomies., Background Patients undergoing relaparotomies are underrepresented in clinical trials. Standard of care, relative outcomes compared to primary laparotomy, and the ideal fascial closure technique are unknown. Objective The ReLap study has three objectives: First, to determine standard of care and gain evidence of intra-/postoperative outcomes for patients undergoing relaparotomy compared to patients undergoing primary laparotomy. Second, to gain evidence of an association between biomarkers and adhesion grade in a clinical-translational approach in patients undergoing relaparotomy or primary laparotomy. Third, to gain evidence of the feasibility and comparative effectiveness of fascial closure after relaparotomy using the small stitches technique with Monomax 2–0 versus the large stitches technique with PDS 1 loop. Methods The ReLap study is a monocentric, prospective, mixed-methods, exploratory study with three steps: health care research, translational research, and randomized controlled trial. All patients scheduled for elective laparotomies or relaparotomies at the University of Heidelberg will be screened for eligibility. There will be five study visits during the hospital stay and one study visit one year after surgery. The clinical course will be followed and outcomes necessary to answer the study objectives will be captured prospectively. Relaparotomy patients eligible for closure with the small and large stitches technique will be randomized intraoperatively to one technique. Discussion The ReLap study will bridge a significant knowledge gap regarding patients undergoing relaparotomy. Differences in the standard of care between relaparotomies and primary laparotomies will be determined. The relation between biomarkers and manifestation of adhesions will be explored and evidence for the comparative effectiveness of fascial closure after relaparotomy will be gained.
- Published
- 2018
9. Use of mixed gas pneumoperitoneum during minimally invasive surgery: a systematic review of human and mouse modelled laparoscopic interventions.
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Chen, Leon, Dasgupta, Prokar, and Vasdev, Nikhil
- Abstract
The formation of pneumoperitoneum involves the process of inflating the peritoneal cavity during laparoscopic and typically uses CO
2 as the insufflation gas. This review aims to identify ideal gas mixtures for establishing the pneumoperitoneum with animal and human studies undertaken up to the writing of this review. A systematic search of PubMed, OVID, and clinicaltrials.gov was performed to identify studies on the utilisation of mixed gases in laparoscopic surgery, including non-randomised/randomised trials, animal and human studies, and studies with inflating pressures between 12 and 16 mmHg. ROBINS-I and RoB2 tool was used to assess the risk of bias. A narrative synthesis of results was performed due to the heterogeneity of the studies. 5 studies from the database search and 5 studies from citation search comprising 128 animal subjects and 61 human patients were found. These studies collated results based on adhesion formation (6 studies), pain scores (2 studies) and other outcomes, with results favouring the use of carbon dioxide + 10% nitrous oxide + 4% oxygen. This has shown a significant reduction in adhesion formation, pain scores and inflammation. The use of this gas mixture provides promising results for future practice. Several of the studies available require larger sample sizes to develop a more definitive answer on the effects of different gas mixtures. Furthermore, the number of confounding factors in randomised trials should be reduced so that each component of the current suggested gas mixture can be tested for safety and efficacy. [ABSTRACT FROM AUTHOR]- Published
- 2024
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10. Preliminary study with SprayShield ™ Adhesion Barrier System in the prevention of abdominal adhesions
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Jacek Karoń, Sławomir Rudzki, Stanisław Malinger, Piotr Krokowicz, Frantisek Antos, Zdenek Kala, Tomasz Banasiewicz, Zoran Stojcev, Karolina Horbacka, and Jyrki Kössi
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Original Paper ,medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,Incidence (epidemiology) ,Gastroenterology ,Obstetrics and Gynecology ,Adhesion (medicine) ,ileostomy ,Adhesion barrier ,adhesions ,medicine.disease ,Ulcerative colitis ,Surgery ,Familial adenomatous polyposis ,Peritoneal cavity ,Ileostomy ,medicine.anatomical_structure ,laparotomy ,Laparotomy ,medicine ,business ,adhesion prevention - Abstract
A b s t r a c t Introduction: Peritoneal adhesions, the fibrotic bands that form between the surfaces in the peritoneal cavity follow - ing surgery, still pose a difficult clinical challenge. Aim:To evaluate the SprayShield™ Adhesion Barrier System (PEG ester amine solution and a buffer solution) in reduc - ing post-operative adhesion formation. Material and methods: This was a prospective, multi-center, randomized, single blind study. A total of 11 subjects diag - nosed with ulcerative colitis (UC) or familial adenomatous polyposis (FAP) were randomized: 8 to the SprayShield™ arm and 3 to the control arm. SprayShield™ was applied on the viscera directly under the midline peritoneal incision and at the site of ileostomy. During the follow-up surgery, the incidence, extent, and severity of post-operative adhe - sion formation were evaluated, as well as the time required to mobilize the ileal loop. Results: In patients who received SprayShield™ the time required to mobilize the ileal loop at the ileostomy closure was slightly shorter and the incidence and severity of adhesions were somewhat lower vs. control subjects (NS). Conclusions: SprayShield™ was found to be easy to use, safe, and quick to apply, and performed well in adherence and conformity. The incidence and severity of adhesions were lower for SprayShield™ subjects vs. control subjects, but due to the limited number of patients there are not enough data to confirm the effectiveness of the SprayShield™ Adhesion Barrier System in prevention of adhesions.
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- 2013
11. Ventralight ST and SorbaFix Versus Physiomesh and Securestrap in a Porcine Model
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Corey R. Deeken and Brent D. Matthews
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Necrosis ,Swine ,Adhesions ,Adhesion (medicine) ,Tissue Adhesions ,Tensile strength ,Masson's trichrome stain ,Postoperative Complications ,Absorbable barrier mesh ,Peritoneum ,Fibrosis ,Implant Capsular Contracture ,Scientific Papers ,medicine ,Animals ,Hernia ,Tissue ingrowth ,Herniorrhaphy ,business.industry ,Equipment Design ,Anatomy ,Surgical Mesh ,medicine.disease ,Hernia, Ventral ,Disease Models, Animal ,Ventral hernia ,medicine.anatomical_structure ,Absorbable fixation ,Female ,Surgery ,Implant ,Contracture ,medicine.symptom ,business - Abstract
Ventralight ST with SorbaFix fixation exhibited more favorable strength of tissue ingrowth and histologic response with similar mesh contracture and adhesion characteristics compared with Physiomesh fixed with Securestrap., Background and Objectives: The objective of this study was to compare mesh contracture, adhesion characteristics, tissue ingrowth, and histologic response of Ventralight ST/SorbaFix (C.R. Bard/Davol, Warwick, RI, USA) with Physiomesh/Securestrap (Ethicon, Somerville, NJ, USA) in a porcine model of laparoscopic ventral hernia repair. Methods: Standard laparoscopic technique was used to bilaterally implant meshes in 10 female Yorkshire swine. Each animal received either two Ventralight ST meshes (oval shaped, 10.2 × 15.2 cm) or two Physiomesh meshes (oval shaped 10 × 15 cm), one on either side of the midline. The meshes were fixated to the intact peritoneum with either SorbaFix (for animals receiving Ventralight ST) or Securestrap (for animals receiving Physiomesh). There were 5 animals in each group, yielding 10 of each mesh-fixation combination. Mesh contracture, adhesion characteristics, tissue ingrowth, and histologic response were evaluated after 14 days by image analysis, mechanical testing, and histologic staining (hematoxylin-eosin, Masson trichrome, picrosirius red, and von Willebrand factor). Results: Ventralight ST/SorbaFix and Physiomesh/Securestrap exhibited a similar percentage of mesh contracture, percentage of adhesion coverage, adhesion tenacity, collagen deposition, and levels of necrosis (P > .05 in all cases). However, Ventralight ST/SorbaFix exhibited significantly less inflammation (P = .0001), fibrosis (P = .0017), hemorrhage (P = .0001), and angiogenesis (P = .0032) and significantly greater strength of tissue ingrowth (P = .0003) than Physiomesh/Securestrap after the 14-day implantation period. Conclusions: Ventralight ST/SorbaFix exhibited more favorable strength of tissue ingrowth and histologic response and similar mesh contracture and adhesion characteristics compared with Physiomesh/Securestrap over a short-term 14-day implantation period in a preclinical porcine model.
- Published
- 2013
12. Preoperative Risk Factors for Intraabdominal Adhesions Should Not Contraindicate Surgical Laparoscopy for Infertility
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Shokeir, Tarek, Badawy, Ahmed, and Abo-Hashem, Hatem
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Adult ,Adhesions ,Contraindications ,Blood Loss, Surgical ,Abdominal Cavity ,Tissue Adhesions ,Postoperative Complications ,Treatment Outcome ,Risk Factors ,Infertility ,Scientific Papers ,Humans ,Laparoscopy ,Female ,Infertility, Female - Abstract
Objective: Abdominal wall adhesions at laparoscopy may predispose infertile patients to access-related injuries and increase the complexity of the procedure. We have observed concern from referring physicians regarding the safety of surgical laparoscopy in infertile patients who previously underwent surgery because of the risk of abdominal adhesions. To assess the risk of intraabdominal adhesions at laparoscopy, a retrospective cohort study was performed. Methods: All infertile patients who underwent a reproductive laparoscopic procedure in a 6-year period at our institution were included in this study. A chart review was performed to obtain demographic/surgical data and identify preoperative risk factors for intraabdominal adhesions. Operative videotapes were reviewed to determine the presence and location of adhesions. Standard statistical analyses were performed. Results: During the study period, 254 infertile patients underwent reproductive surgical laparoscopy, and videotapes on 164 (65%) were available for review. A total of 88 patients (54%) were identified with preoperative risk factors for intraabdominal adhesions (group 1), while 76 (46%) had no risk factors (group 2). The relative risk of adhesions was 1.34 (95% CI, range 0.89 to 2.01, P=0.18) when risk factors were identified. There were no differences in the groups regarding patient age, operative time, access technique, conversion to open surgery, or complications. Estimated blood loss was significantly higher in group 2, likely due to the predominance of laparoscopic surgery for ovarian endometriomata and complexity of the cases rather than the presence or absence of intraabdominal adhesion risk factors. Conclusions: No difference existed in the risk of intra-abdominal adhesions in infertile patients with and without identifiable preoperative risk factors. Preoperative risk factors for intraabdominal adhesions should not contraindicate the surgical laparoscopic approach for reproductive procedures.
- Published
- 2008
13. Minimal adhesions to ePTFE mesh after laparoscopic ventral incisional hernia repair: reoperative findings in 65 cases
- Author
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David H. Berger, Roy Smoot, Karl A. LeBlanc, Guy R. Voeller, Steve Carey, Dennis Begos, Richard H. Koehler, Bruce Ramshaw, and Adrian Park
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Adult ,Male ,Reoperation ,medicine.medical_specialty ,Time Factors ,Adhesions ,medicine.medical_treatment ,Adhesion (medicine) ,Hernia, Inguinal ,Tissue Adhesions ,Expanded polytetrafluoroethylene ,Severity of Illness Index ,Prosthesis ,Ventral incisional hernia ,Postoperative Complications ,Surveys and Questionnaires ,Clinical information ,Scientific Papers ,medicine ,Humans ,In patient ,Laparoscopy ,Polytetrafluoroethylene ,Aged ,Retrospective Studies ,Titanium ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Incisional hernia repair ,Middle Aged ,Surgical Mesh ,medicine.disease ,Hernia, Ventral ,Surgery ,Female ,Safety ,business ,Follow-Up Studies - Abstract
Background and Objectives: Laparoscopic ventral incisional hernia repair involves intraabdominal placement of a synthetic mesh, and the possibility of formation of severe visceral adhesions to the prosthesis is a principal concern. Little clinical information based on reoperative findings is available about adhesions to biomaterials placed intraabdominally. We conducted a multi-institutional study of adhesions to implanted expanded polytetrafluoroethylene (ePTFE) mesh at reoperation in patients who had previously undergone laparoscopic incisional hernia repair done with the same mesh implantation technique. Methods: Nine surgeons retrospectively assessed the severity of adhesions to ePTFE mesh at reoperation in 65 patients. For each case, adhesions were assigned a score of 0 to 3, with 0 indicating no adhesions and 3 severe adhesions. Results: The mean time from mesh implantation to reoperation was 420 days (range, 2-1739 days). No adhesions were observed in 15 cases. Forty-four cases received an adhesion score of 1, and 6 cases a score of 2; no scores of 3 were assigned. Thus, 59 patients (91 %) had either no or filmy, avascular adhesions. No enterotomies occurred during adhesiolysis. Conclusions: In this large series of reoperations after laparoscopic incisional hernia repair, no or minimal formation of adhesions to implanted ePTFE mesh was observed in 91% of cases, and no severe cohesive adhesions were found. Comparative analyses of newer materials based on clinical reoperative findings are warranted to assess the safety of intraabdominally placed meshes.
- Published
- 2003
14. Adhesions and Adhesiolysis: The Role of Laparoscopy
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Kavic, Stephen M. and Kavic, Suzanne M.
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Postoperative Complications ,Adhesiolysis ,Adhesions ,Scientific Papers ,Humans ,Laparoscopy ,Tissue Adhesions - Abstract
Background: Adhesions commonly result from abdominal and pelvic surgical procedures and may result in intestinal obstruction, infertility, chronic pain, or complicate subsequent operations. Laparoscopy produces less peritoneal trauma than does conventional laparotomy and may result in decreased adhesion formation. We present a review of the available data on laparoscopy and adhesion formation, as well as laparoscopic adhesiolysis. We also review current adjuvant techniques that may be used by practicing laparoscopists to prevent adhesion formation. Database: A Medline search using “adhesions,” “adhesiolysis,” and “laparoscopy” as key words was performed for English-language articles. Further references were obtained through cross-referencing the bibliography cited in each work. Discussion: The majority of studies indicate that laparoscopy may reduce postoperative adhesion formation relative to laparotomy. However, laparoscopy by itself does not appear to eliminate adhesions completely. A variety of adjuvant materials are available to surgeons, and the most recent investigation has demonstrated significant potential for intraperitoneal barriers. Newer technologies continue to evolve and should result in clinically relevant reductions in adhesion formation.
- Published
- 2002
15. Diagnostic laparoscopy and adhesiolysis: does it help with complex abdominal and pelvic pain syndrome (CAPPS) in general surgery?
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Steven D McCarus, Gregory D. McClain, Jay A Redan, John C. Kim, and Aileen Caceres
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Pelvic pain syndrome ,Adult ,Male ,Abdominal pain ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Adhesions ,Adhesion (medicine) ,Diagnostic laparoscopy ,Tissue Adhesions ,Pelvic Pain ,Young Adult ,medicine ,Scientific Papers ,Humans ,In patient ,Retrospective Studies ,Pain, Postoperative ,business.industry ,General surgery ,Syndrome ,Middle Aged ,medicine.disease ,Surgery ,Bowel obstruction ,Amputation ,Chronic Disease ,Female ,Laparoscopy ,medicine.symptom ,business ,Phantom pain ,Algorithms - Abstract
This study was conducted to determine if lysis of bowel adhesions has a role in the surgical management of adhesions for treating complex abdominal and pelvic pain syndrome., Abdominal pains secondary to adhesions are a common complaint, but most surgeons do not perform surgery for this complaint unless the patient suffers from a bowel obstruction. The purpose of this evaluation was to determine if lysis of bowel adhesions has a role in the surgical management of adhesions for helping treat abdominal pain. The database of our patients with complex abdominal and pelvic pain syndrome (CAPPS) was reviewed to identify patients who underwent a laparoscopic lysis of adhesion without any organ removal and observe if they had a decrease in the amount of abdominal pain after this procedure. Thirty-one patients completed follow-up at 3, 6, 9, and 12 months. At 6, 9, and 12 months postoperation, there were statistically significant decreases in patients' analog pain scores. We concluded that laparoscopic lysis of adhesions can help decrease adhesion-related pain. The pain from adhesions may involve a more complex pathway toward pain resolution than a simple cutting of scar tissue, such as “phantom pain” following amputation, which takes time to resolve after this type of surgery.
- Published
- 2011
16. A new material for prevention of peritendinous fibrotic adhesions after tendon repair: oxidised regenerated cellulose (Interceed), an absorbable adhesion barrier
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K. Kara, Tufan Kaleli, Aytun Temiz, A. Bakunov, Cagatay Ozturk, Uludağ Üniversitesi/Tıp Fakültesi/Ortopedik Cerrahi Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı., Temiz, Atiye, Kara, Kurşat, Kaleli, Tufan, Bakunov, Ayvaz, W-4795-2018, and S-6686-2019
- Subjects
Rats, wistar ,Fibrin sealant ,Adhesions ,Wound infection ,Adhesion (medicine) ,Tissue Adhesions ,Injury ,Rabbit ,Animal tissue ,Orthopedics and Sports Medicine ,5-fluorouracil ,Wound dehiscence ,Priority journal ,Tissue Adhesion ,Achilles tendon ,Cellulose, oxidized ,Orthopedic procedures ,musculoskeletal system ,Tendon ,Tendon sheath ,Zone-ıı ,medicine.anatomical_structure ,Adhesion ,Female ,musculoskeletal diseases ,medicine.medical_specialty ,Histology ,Amniotic membrane ,Wound healing ,Absorbable implants ,Article ,Intraoperative period ,medicine ,Postoperative period ,Animals ,Animal experiment ,Reduction ,Inflammation ,Original Paper ,Flexors ,Tendon Injuries ,Gapping ,business.industry ,Adhesion barrier ,medicine.disease ,Nonhuman ,Fibrosis ,Surgery ,Rats ,Orthopedics ,Oxidized regenerated cellulose ,Tendon reconstruction ,Rat ,business ,Chickens ,Model - Abstract
In this experimental study, we aimed to examine the ability of absorbable oxidised regenerated cellulose (Interceed, TC-7, Johnson & Johnson, USA) to inhibit the formation of peritendinous fibrotic adhesions after tendon repair in rats. Both Achilles tendons of 23 female Wistar-Albino rats weighing between 350 and 450 grams were cut and repaired. On the right side, Interceed absorbable adhesion barriers were wrapped around the repaired tendon (group I). On the left, the same procedures were applied except for the Interceed wrapping and these were grouped as control (group II). Animals were sacrificed at postoperative day 28 and macroscopic and histological examination was performed. All the animals survived and no tendon rupture was observed. No wound dehiscence, wound infection or exposure of repaired tendons occurred. Macroscopically, there were three (13.1%) tendons without adhesion formation and 20 (86.9%) tendons with inferior adhesion formation in group I; on the other hand, there were 16 tendons (69.5%) with medium grade adhesion formation and seven tendons (30.5%) with severe peritendinous adhesion formation in group II (control group) (p
- Published
- 2008
17. Laparoscopic evaluation of abdominal adhesions with different prosthetic meshes in rabbits
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Wagner, Marcondes, Fernando A M, Herbella, Jacques, Matone, Alexandre N, Odashiro, and Alberto, Goldenberg
- Subjects
Mesh ,Adhesions ,Abdominal Wall ,Prosthetic materials ,Scientific Papers ,Animals ,Hernia repair ,Laparoscopy ,Tissue Adhesions ,Rabbits ,Rabbit ,Surgical Mesh - Abstract
Background: The use of prosthetic materials to reinforce the abdominal wall is associated with a low index of recurrence; however, intraperitoneal placement of a foreign body may lead to adhesions. The present investigation was designed to determine adhesion formation with commercially available meshes implanted laparoscopically in rabbits. Methods: Three different meshes were implanted laparoscopically in 24 rabbits: polypropylene (mesh A), polypropylene and sodium hyaluronate-carboxymethylcellulose (mesh B), and polypropylene and expanded polytetrafluoroethylene (mesh C). Sites of implantation for each mesh (the left lower quadrant, right lower quadrant, and lower midline) were randomly determined so that every rabbit had all 3 meshes implanted. All animals underwent diagnostic laparoscopy after 28 days to grade adhesions and histological analysis of inflammation. Results: Adhesions were noticed in 46 of the 72 meshes implanted (64%). The number of adhesions was higher for mesh C (87.5%) compared with meshes A (62.5%) and B (41.6%). The severity of adhesions was also higher for mesh C (grade I in 14, II in 6, and III in 1) compared with mesh A (grade I in 10, II in 4, and III in 1 case) and B (all of them grade II). Histological inflammatory reaction was classified as mild in 23 cases of mesh A, 15 of mesh B, and 23 of mesh C. A moderate reaction was found in 1 case of mesh A, 4 cases of mesh B, and 1 case of mesh C. Severe reaction was induced in 5 cases of mesh B. Mesh B induced a higher inflammatory reaction compared with the other meshes. Conclusions: All meshes induced adhesions of different grades. Mesh B had fewer adhesions and more intense inflammation them did the others.
- Published
- 2008
18. Role of laparoscopy in identifying the clinical significance and cause of adhesions and chronic pelvic pain: a retrospective review at the Kiel School of Gynecological Endoscopy
- Author
-
Liselotte, Mettler and Maher, Alhujeily
- Subjects
Male ,Adhesiolysis ,Adhesions ,Abdomen ,Chronic Disease ,Scientific Papers ,Humans ,Female ,Laparoscopy ,Tissue Adhesions ,Pelvic Pain ,Retrospective Studies - Abstract
Objectives: We sought to define the role of laparoscopy in identifying the clinical significance, cause, and association between adhesions and chronic pelvic pain. Methods: A retrospective chart review was conducted from October 2004 to July 2005, at the Kiel School of Gynecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Germany. Included in the study was the analysis of 462 laparoscopic procedures; 275 (59.5%) of the patients undergoing these procedures had pelvic or abdominal adhesions. Of these, 84 (30.5%) patients were admitted with the main complaint of chronic pelvic pain. Further evaluation and assessment of this group was carried out. Results: Among those patients with adhesions, the second most frequent reason for admission was chronic pelvic pain (30.5%) (P
- Published
- 2007
19. Prevalence of infraumbilical adhesions in women with previous laparoscopy
- Author
-
Vicken, Sepilian, Lowell, Ku, Herb, Wong, C Y, Liu, and John Y, Phelps
- Subjects
Adult ,Reoperation ,Adolescent ,Adhesions ,Tissue Adhesions ,Umbilical incision ,Middle Aged ,Gynecologic Surgical Procedures ,Abdomen ,Scientific Papers ,Humans ,Female ,Laparoscopy ,Aged - Abstract
Background and Objectives: The aim of this study is to evaluate the prevalence of intraabdominal adhesions to the umbilicus following gynecologic laparoscopy through an umbilical incision. Methods: A retrospective review was performed of all gynecologic laparoscopic procedures in a private practice setting to identify patients with a repeat laparoscopy who had a history of a previous laparoscopy through an umbilical incision. Patients with a history of other surgeries were excluded. All repeat laparoscopies used a left upper quadrant entry technique where the abdominal cavity was surveyed for adhesions. We also reviewed adverse events attributable to the left upper quadrant entry approach. Results: We identified 151 patients who underwent a second laparoscopy and had a previous umbilical scar. Thirty-two of the 151 (21.2%) patients with a history of a laparoscopy had evidence of adhesions to the umbilical undersurface. No adverse events or injuries were attributed to the left upper quadrant entry technique. Conclusions: Adhesions to the umbilical undersurface occur in 21.2% of patients who have undergone a prior laparoscopy through an umbilical incision. For this reason, we recommend an alternate location for entry in patients with an umbilical scar from a previous laparoscopy.
- Published
- 2007
20. Postoperative Adhesion Formation in a Rabbit Model: Monopolar Electrosurgery Versus Ultrasonic Scalpel
- Author
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Farr R. Nezhat, Patrick F. Vetere, George Lazarou, Radu Apostol, Poonam Khullar, and Linda Okonkwo
- Subjects
medicine.medical_specialty ,Ultrasonic Therapy ,Adhesions ,Electrosurgery ,Adhesion (medicine) ,Tissue Adhesions ,Postoperative Complications ,Energy sources ,Scientific Papers ,medicine ,Harmonic scalpel ,Animals ,Laparoscopy ,medicine.diagnostic_test ,business.industry ,Dissection ,Uterine horns ,Monopolar electrosurgery ,equipment and supplies ,medicine.disease ,Surgery ,surgical procedures, operative ,Models, Animal ,Ultrasonic sensor ,Rabbits ,business ,Energy source ,Ultrasonic dissection - Abstract
Background and Objectives: To determine if surgery using ultrasonic energy for dissection results in less adhesion formation than monopolar electrosurgical energy in the late (8 weeks) postoperative period. Methods: Injuries were induced in rabbits by using ultrasonic energy on one uterine horn and the adjacent pelvic sidewall and using monopolar energy on the opposite side. Eight weeks postoperatively, the rabbits underwent autopsy and clinical and pathologic scoring of adhesions was performed by blinded investigators. Results: There was no significant difference in clinical adhesion scores between the two modalities. The mean clinical score for monopolar cautery was 1.00 versus 0.88 for the Harmonic device (Ethicon Endo-Surgery, Cincinnati, Ohio) (P = .71). Furthermore, there was no significant difference found in the pathologic adhesion scores between the ultrasonic scalpel and monopolar energy. The mean pathologic score for monopolar electrosurgery was 4.35 versus 3.65 for the Harmonic scalpel (P = .30). Conclusion: Neither monopolar electrosurgery nor ultrasonic dissection is superior in the prevention of adhesion formation in the late postoperative period.
- Published
- 2015
21. Laparoscopic incisional and ventral hernia repair (LIVH): an evolving outpatient technique
- Author
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G Kevin, Gillian, W Peter, Geis, and Gary, Grover
- Subjects
Mesh ,Ventral hernia ,Laparoscopic hernioplasty ,Recurrence ,Adhesions ,Prosthetic materials ,Scientific Papers ,Laparoscopy ,Surgical Mesh ,Polytetrafluoroethylene ,Incisional hernia ,Hernia, Ventral - Abstract
Background and Objectives: The contemporary results of open incisional and ventral hernia repair are unsatisfactory because of high recurrence rates and morbidity levels. Laparoscopic repair of ventral and incisional hernias (LIVH) can be accomplished in a simple, reproducible manner while dramatically lowering recurrence rates and morbidity. Methods: One hundred consecutive patents underwent laparoscopic repair of their ventral and incisional hernias over a 27-month period. Composix mesh and Composix E/X mesh (Davol Inc., Cranston, RI) were utilized for the repairs. Transfixion sutures were not used. Results: All repairs were completed laparoscopically. No conversions to open techniques were necessary. No postoperative infections have been observed. One recurrent hernia was identified and subsequently repaired with the same technique. Conclusions: LIVH can be accomplished with a dramatic reduction in recurrence rates and morbidity. The technique for this repair is still in a state of evolution. The construction and handling characteristics of this particular type of mesh have allowed us to eliminate transfixion sutures and to simplify the repair technique while maintaining a very low recurrence rate.
- Published
- 2002
22. Interdyscyplinarne leczenie powikłań operacyjnych w ginekologii onkologicznej.
- Author
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Nowak, Anna, Szubert, Maria, and Suzin, Jacek
- Abstract
Copyright of Current Gynecologic Oncology is the property of Medical Communications Sp. z o.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2018
- Full Text
- View/download PDF
23. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group
- Author
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ten Broek, Richard PG, Krielen, Pepijn, Di Saverio, Salomone, Coccolini, Federico, Biffl, Walter L, Ansaloni, Luca, Velmahos, George C, Sartelli, Massimo, Fraga, Gustavo P, Kelly, Michael D, Moore, Frederick A, Peitzman, Andrew B, Leppaniemi, Ari, Moore, Ernest E, Jeekel, Johannes, Kluger, Yoram, Sugrue, Michael, Balogh, Zsolt J, Bendinelli, Cino, Civil, Ian, Coimbra, Raul, De Moya, Mark, Ferrada, Paula, Inaba, Kenji, Ivatury, Rao, Latifi, Rifat, Kashuk, Jeffry L, Kirkpatrick, Andrew W, Maier, Ron, Rizoli, Sandro, Sakakushev, Boris, Scalea, Thomas, Søreide, Kjetil, Weber, Dieter, Wani, Imtiaz, Abu-Zidan, Fikri M, De’Angelis, Nicola, Piscioneri, Frank, Galante, Joseph M, Catena, Fausto, and van Goor, Harry
- Subjects
Patient Safety ,Prevention ,Digestive Diseases ,Clinical Research ,Evaluation of treatments and therapeutic interventions ,7.3 Management and decision making ,6.4 Surgery ,Management of diseases and conditions ,Oral and gastrointestinal ,Disease Management ,General Surgery ,Guidelines as Topic ,Humans ,Intestinal Obstruction ,Tissue Adhesions ,Treatment Outcome ,Small bowel obstruction ,Adhesions ,Surgery ,Laparoscopy ,Laparotomy - Abstract
BackgroundAdhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups.MethodsThe guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group. A systematic literature search was performed prior to the update of the guidelines to identify relevant new papers on epidemiology, diagnosis, and treatment of ASBO. Literature was critically appraised according to an evidence-based guideline development method. Final recommendations were approved by the workgroup, taking into account the level of evidence of the conclusion.RecommendationsAdhesion formation might be reduced by minimally invasive surgical techniques and the use of adhesion barriers. Non-operative treatment is effective in most patients with ASBO. Contraindications for non-operative treatment include peritonitis, strangulation, and ischemia. When the adhesive etiology of obstruction is unsure, or when contraindications for non-operative management might be present, CT is the diagnostic technique of choice. The principles of non-operative treatment are nil per os, naso-gastric, or long-tube decompression, and intravenous supplementation with fluids and electrolytes. When operative treatment is required, a laparoscopic approach may be beneficial for selected cases of simple ASBO.Younger patients have a higher lifetime risk for recurrent ASBO and might therefore benefit from application of adhesion barriers as both primary and secondary prevention.DiscussionThis guideline presents recommendations that can be used by surgeons who treat patients with ASBO. Scientific evidence for some aspects of ASBO management is scarce, in particular aspects relating to special patient groups. Results of a randomized trial of laparoscopic versus open surgery for ASBO are awaited.
- Published
- 2018
24. MR imaging for preoperative characterization of pelvic adhesions: role in diagnosis and surgical planning
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Ahmed, Taha M., Coco, Abigail, Vaught, Arthur J., and Gomez, Erin N.
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- 2024
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- View/download PDF
25. Analysis of aborted bariatric surgeries and potential opportunities
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Pearl, Leah M., Varban, Oliver A., Bonham, Aaron J., Stricklen, Amanda, Kia, Michael A., Finks, Jonathan F., and Carlin, Arthur M.
- Published
- 2024
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- View/download PDF
26. Effects of linalool on postoperative peritoneal adhesions in rats
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Davoodi, Farshid, Azizi, Saeed, Aghazadeh, Safiyeh, and Dezfoulian, Omid
- Published
- 2024
- Full Text
- View/download PDF
27. The impact of previous abdominal surgery on colorectal cancer patients undergoing laparoscopic surgery
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Liu, Xu-Rui, Zhang, Bing-Lan, Peng, Dong, Liu, Fei, Li, Zi-Wei, and Wang, Chun-Yi
- Published
- 2024
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28. An Analysis of the VELNEZ Nasal Pack’s Acceptability and Safety for Use During Nasal Surgery: A Prospective Study
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Singh, Akhil Pratap, Singh, Saloni, Malik, Ridhima, Gupta, Ritu, and Pandey, Siddharth
- Published
- 2024
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29. Does intraperitoneal mesh increase the risk of bowel obstruction? A nationwide French analysis
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Delorme, Théophile, Cottenet, Jonathan, Abo-Alhassan, Fawaz, Bernard, Alain, Ortega-Deballon, Pablo, and Quantin, Catherine
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- 2024
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- View/download PDF
30. Adhesions and Colorectal Surgery – Call for Action.
- Author
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Parker, M. C., Wilson, M. S., van Goor, H., Moran, B. J., Jeekel, J., Duron, J-J., Menzies, D., Wexner, S. D., and Ellis, H.
- Subjects
TISSUE adhesions ,COLON surgery ,ABDOMINAL surgery ,PELVIC bones ,CLINICAL medicine ,SURGERY - Abstract
Mounting evidence highlights that adhesions are now the most frequent complication of abdominopelvic surgery, yet many surgeons are still not aware of the extent of the problem and its serious consequences. While many patients go through life without apparent problems, adhesions are the major cause of small bowel obstruction and a leading cause of infertility and chronic pelvic pain in women. Moreover, adhesions complicate future abdominal surgery with important associated morbidity and expense and a considerable risk of mortality. Studies have shown that despite advances in surgical techniques in recent years, the burden of adhesion-related complications has not changed. Adhesiolysis remains the main treatment even though adhesions reform in most patients. Recent developments in adhesion-reduction strategies and new anti-adhesion agents do, however, offer a realistic possibility of reducing the risk of adhesions forming and potentially improving the clinical outcomes for patients and reducing the associated onward burden to healthcare systems. This paper provides a synopsis of the impact and extent of the problem of adhesions with reference to the wider literature and also consideration of the key note papers presented in this special supplement to Colorectal Disease. It considers the evidence of the risk of adhesions in colorectal surgery and the opportunities and strategies for improvement. The paper acts as a ‘call for action’ to colorectal surgeons to make prevention of adhesions more of a priority and importantly to inform patients of the risks associated with adhesion-related complications during the consent process. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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- View/download PDF
31. A Systematic Review and Meta-Analysis for Surgical Techniques Intended to Alleviate Post-Operative Adhesions Following Abdominal and Pelvic Surgery.
- Author
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Allehaiby, Ahmad Hameed, Aldosari, Asal Suweid Abduallh, Alalwani, Mohammed Anwar, Karbouji, Rayan Ali, Alzain, Esra Hassan, Al Basheiti, Khaled Mohammad, Abduljawad, Sulafah Sameer, Alwaheed, Areej Abdulaziz, Alabbasi, Salah Mahmoud Salah, Kharsan, Bayan Abdulkarim F., Alasmari, Hassan Ibrahim, Alotaibi, Abdullah Ghazzai G., Boudal, Anwar Khalid, Boudal, Ethar Ahmad, and Qaq, Waseem Morshed
- Subjects
- *
ABDOMINAL surgery , *PELVIC surgery , *SYSTEMATIC reviews , *SURGICAL technology , *POSTOPERATIVE care , *SURGICAL complications , *RANDOMIZED controlled trials - Abstract
Background: postoperative peritoneal adhesions are common and frequent complication following abdominal and Pelvic Surgery. Adhesions can lead to bowel obstructions and infertility in women (when they develop around the reproductive organs), chronic pain which consequently results in reducing the quality of life for patients, level of energy, productivity, and increase the risk, complexity and chance of complications in subsequent surgeries. Main objective of this review is to study the implication of using the 'good surgical techniques' in the prevention of postoperative adhesions. Methods: the present review included randomized controlled trials (RCTs) that investigated the different surgical technique impact on adhesion-related outcomes were identified through search in Pubmed, CENTRAL and Embase. Identified endpoints were: clinical outcomes and incidence of adhesions. The primary Identification of papers and data extraction were performed by independent researchers. Results: out of 1709 studies, there were only 21 papers eligible for a systematic review and included in the meta-analysis and qualitative assessment. None of the techniques that were compared significantly reduced the incidence of adhesive small bowel obstruction. In a small low-quality trial, the pregnancy rate increased after subserous fixation of suture knots. However, the incidence of adhesions was lower after laparoscopic compared with open surgery [relative risk (RR) 0.14; 95% confidence interval (CI): 0.03-0.61] and when the peritoneum was not closed (RR 0.36; 95% CI: 0.21-0.63). Conclusion: None of the specific techniques that were compared reduced the two main adhesion-related clinical outcomes, small bowel obstruction and infertility. The meta-analysis provides some evidence for the surgical principle that using less invasive techniques, introducing less foreign bodies or causing less ischemia reduces the extent and severity of adhesions. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
32. From Adhesion to Detachment: Strategies to Design Tissue‐Adhesive Hydrogels.
- Author
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Ho, Minh Hieu, van Hilst, Quinn, Cui, Xiaolin, Ramaswamy, Yogambha, Woodfield, Tim, Rnjak-Kovacina, Jelena, Wise, Steven G., and Lim, Khoon S.
- Subjects
HYDROGELS ,FIBRIN tissue adhesive ,GLUE ,ADHESIVES ,BIOMEDICAL adhesives - Abstract
The use of tissue adhesives dates to 1940s when surgical glues were introduced for wound closure applications. However, current clinically used tissue adhesives (fibrin and cyanoacrylate glues) have limited adhesion strength and biocompatibility issues which restrict their performance in targeted applications. Due to this unmet clinical challenge, there is a need to develop next‐generation tissue adhesives to expand the current limited available options. Another factor that is often overlooked in the field is the consequence of when these tissue adhesives fail while in use in specific applications. In this review, the complications arising from tissue adhesives that have insufficient adhesion strength are covered, where unintentional loosening and detachment can lead to serious complications depending on both the applications and scenarios in which the adhesives are used. Next, the current methodologies employed to design tissue‐adhesive hydrogels targeting specific applications are also collated. Finally, the different strategies to engineer on‐demand removal property of these tissue‐adhesive hydrogels are consolidated, including some perspectives on current challenges and outlooks in this field. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
33. The risk of postoperative complications is higher in stage I-III colorectal cancer patients with previous abdominal surgery: a propensity score matching analysis
- Author
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Liu, Xu-Rui, Liu, Fei, Li, Zi-Wei, Liu, Xiao-Yu, Zhang, Wei, and Peng, Dong
- Published
- 2023
- Full Text
- View/download PDF
34. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group
- Author
-
Richard P. G. ten Broek, Pepijn Krielen, Salomone Di Saverio, Federico Coccolini, Walter L. Biffl, Luca Ansaloni, George C. Velmahos, Massimo Sartelli, Gustavo P. Fraga, Michael D. Kelly, Frederick A. Moore, Andrew B. Peitzman, Ari Leppaniemi, Ernest E. Moore, Johannes Jeekel, Yoram Kluger, Michael Sugrue, Zsolt J. Balogh, Cino Bendinelli, Ian Civil, Raul Coimbra, Mark De Moya, Paula Ferrada, Kenji Inaba, Rao Ivatury, Rifat Latifi, Jeffry L. Kashuk, Andrew W. Kirkpatrick, Ron Maier, Sandro Rizoli, Boris Sakakushev, Thomas Scalea, Kjetil Søreide, Dieter Weber, Imtiaz Wani, Fikri M. Abu-Zidan, Nicola De’Angelis, Frank Piscioneri, Joseph M. Galante, Fausto Catena, and Harry van Goor
- Subjects
Small bowel obstruction ,Adhesions ,Surgery ,Laparoscopy ,Laparotomy ,RD1-811 ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background Adhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups. Methods The guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group. A systematic literature search was performed prior to the update of the guidelines to identify relevant new papers on epidemiology, diagnosis, and treatment of ASBO. Literature was critically appraised according to an evidence-based guideline development method. Final recommendations were approved by the workgroup, taking into account the level of evidence of the conclusion. Recommendations Adhesion formation might be reduced by minimally invasive surgical techniques and the use of adhesion barriers. Non-operative treatment is effective in most patients with ASBO. Contraindications for non-operative treatment include peritonitis, strangulation, and ischemia. When the adhesive etiology of obstruction is unsure, or when contraindications for non-operative management might be present, CT is the diagnostic technique of choice. The principles of non-operative treatment are nil per os, naso-gastric, or long-tube decompression, and intravenous supplementation with fluids and electrolytes. When operative treatment is required, a laparoscopic approach may be beneficial for selected cases of simple ASBO. Younger patients have a higher lifetime risk for recurrent ASBO and might therefore benefit from application of adhesion barriers as both primary and secondary prevention. Discussion This guideline presents recommendations that can be used by surgeons who treat patients with ASBO. Scientific evidence for some aspects of ASBO management is scarce, in particular aspects relating to special patient groups. Results of a randomized trial of laparoscopic versus open surgery for ASBO are awaited.
- Published
- 2018
- Full Text
- View/download PDF
35. Adhesive small bowel obstruction: aspects on epidemiology, treatment, costs and prevention
- Author
-
Sakari, Thorbjörn B.
- Subjects
acute surgery ,small bowel obstruction ,Kirurgi ,colorectal cancer ,Surgery ,adhesions - Abstract
Small bowel obstruction (SBO) is a common and sometimes life-threatening clinical condition, usually caused by post-operative adhesions. The aims of this thesis were to investigate the outcome after SBO surgery (Paper I), cost of SBO surgery including follow-up (Paper II), incidence of SBO after colorectal cancer (CRC) surgery (Paper III), and to assess the safety of using the adhesion preventing substance icodextrin in CRC surgery (Paper IV). Paper I, a population-based retrospective study on all patients operated for adhesive SBO (n=402) in the Uppsala and Gävleborg counties between 2007 and 2012. The SBO mechanism was a fibrous band in 56%. Complications and reoperations were recorded in 48% and 10% of patients, respectively. Complications, ICU care and early mortality were associated with age and ASA class. Seventy two patients had a recurrence of SBO, 26 of whom were re-operated. Previous laparotomies, diffuse adhesions, and complicated surgery (bowel injury, longer operation times and bleeding) were predictors of recurrent SBO. Paper II used the same cohort as in Paper I with an extended follow-up (8 years in median). Mean total cost estimates per patients were €40,467 during the study period. Diffuse adhesions and complications were associated with increased costs for SBO in a multivariable analysis (p
- Published
- 2023
36. Adhérences postopératoires et leur prévention en chirurgie gynécologique : II. Comment les prévenir ?
- Author
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Pouly, J.-L., Darai, E., Yazbeck, C., Benifla, J.-L., Dechaud, H., Wattiez, A., Crowe, A., and Audebert, A.
- Subjects
- *
TISSUE adhesions , *SURGICAL complications , *SCARS , *GYNECOLOGIC surgery , *TREATMENT effectiveness , *SURGEONS , *PREVENTION - Abstract
Abstract: This paper is the second of a two-part publication. The initial paper provided a comprehensive overview of the evidence on adhesions to allow gynaecological surgeons to be best informed on adhesions, their development, impact on patients, health systems and surgical outcomes. There is rising evidence that surgeons can take important steps to reduce the burden of adhesions. In this second paper, we review the various strategies to reduce the impact of adhesions, improve surgical outcomes and provide some practical proposals for action on adhesions. As well as improvements in surgical technique, developments in adhesion-reduction strategies and new agents offer a realistic possibility of reducing adhesion formation and improving outcomes for patients. They should be considered for use particularly in high-risk surgery and in patients with adhesiogenic conditions. Further research into new strategies to prevent adhesions more effectively through an improved surgical environment, new and combination devices and pharmacological agents should be encouraged. Formal recommendations would ensure better prioritisation of adhesion-reduction within the French health system. Patients should also be better informed of the risks of adhesions. [Copyright &y& Elsevier]
- Published
- 2012
- Full Text
- View/download PDF
37. Adhérences postopératoires et leur prévention en chirurgie gynécologique : I. Ce qu’il faut savoir
- Author
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Audebert, A., Darai, E., Bénifla, J.-L., Yazbeck, C., Déchaud, H., Wattiez, A., Crowe, A., and Pouly, J.-L.
- Subjects
- *
SURGICAL complications , *TISSUE adhesions , *INFERTILITY , *PELVIC pain , *QUALITY of life , *LAPAROSCOPY - Abstract
Abstract: Adhesions are the most frequent complications of abdominopelvic surgery, causing important short- and long-term problems, including infertility, chronic pelvic pain and a lifetime risk of small bowel obstruction. They also complicate future surgery with increased morbidity and mortality risk. They pose serious quality of life issues for many patients with associated social and healthcare costs. Despite advances in surgical techniques, including laparoscopy, the healthcare burden of adhesion-related complications has not changed in recent years. Adhesiolysis remains the main treatment although adhesions reform in many patients. The extent of the problem of adhesions has been underestimated by surgeons and the health authorities. There is rising evidence however that surgeons can take important steps to reduce the impact of adhesions. As well as improvements in surgical technique, developments in adhesion-reduction strategies and new agents offer a realistic possibility of reducing adhesion formation and improving outcomes for patients. This paper is the first of a two-part publication providing a comprehensive overview of the evidence on adhesions to allow gynaecological surgeons to be best informed on adhesions, their development, impact on patients, health systems and surgical outcomes. In the second paper we review the various strategies to reduce the impact of adhesions and improve surgical outcomes to assist fellow surgeons in France to consider the adoption of adhesion reduction strategies in their own practice. [Copyright &y& Elsevier]
- Published
- 2012
- Full Text
- View/download PDF
38. Evolving Management Strategies in Patients with Adhesive Small Bowel Obstruction: a Population-Based Analysis
- Author
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Behman, Ramy, Nathens, Avery B., Look Hong, Nicole, Pechlivanoglou, Petros, and Karanicolas, Paul J
- Published
- 2018
- Full Text
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39. Fetal ascites in cloacal malformations—a red flag
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Abdelmaksoud, Sherif, Lobo, Sara, Cho, Alexander, Upasani, Anand, Blackburn, Simon, Curry, Joe, Davies, Brian, Martin, Ruppert, De Win, Gunter, and Cherian, Abraham
- Published
- 2023
- Full Text
- View/download PDF
40. Model for assessment of mobility of toes and healing of tendons in rabbits.
- Author
-
Olmarker, Kjell, Ekström, Lars, Håkansson, Joakim, Nilsson, Elin, Wiig, Monica, and Mahlapuu, Margit
- Subjects
FLEXOR tendons ,TOE abnormalities ,TISSUE adhesions ,LABORATORY rabbits ,METATARSUS ,BIOMECHANICS ,SURGERY - Abstract
Repair of a transected flexor tendon will, despite careful technique and early rehabilitation, usually result in a restricted range of movement. This is mainly because adhesions form between the tendon and the surrounding structures. Our aim was to establish an experimental model in rabbits for future studies on new techniques to reduce the formation of adhesions after zone II repair of flexor tendons. In rabbits' hind paws the metatarsal bones II, IV, and V were removed and the flexor tendon was freed to the metatarsophalangeal (MTP) joint. The digits were secured in a specifically-designed biomechanical testing device comprising a servo-hydraulic actuator that was designed to apply controlled force or displacement. The tests were videotaped with a digital force-monitor behind the tested digit. Paper printouts from the recordings were obtained for 0, 0.5, 1, 2, 3, 4, and 5 Newton (N) and metatarsophalangeal, proximal interphalangeal, and distal interphalangeal, angles and distances between metatarsophalangeal joints and claws were measured. The tensile strength of the tendon was evaluated by a load-to-failure test. The continuous data obtained from the experiments were used to calculate functional stiffness at the selected forces. The model allows for unique continuous recordings of mobility of toes, thereby indirectly quantifying the presence of adhesions and the assessment of tensile strength. The data are reproducible, and there is little variation between the digits tested. The model is primarily intended to compare data among treated and non-treated digits of methods to limit the formation of adhesions after tendons have been repaired. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
41. Laparoskopische Behandlung der adhäsionsbedingten Dünndarmobstruktion.
- Author
-
Bergamaschi, R.
- Abstract
Copyright of Colo-Proctology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2010
- Full Text
- View/download PDF
42. Laparoscopic management of adhesive small bowel obstruction.
- Author
-
Essani, R. and Bergamaschi, R.
- Subjects
BOWEL obstructions ,DISEASES -- Management ,LAPAROSCOPIC surgery ,ENDOSCOPIC surgery ,SURGICAL complications ,TISSUE adhesions - Abstract
The objective of this review is to present a current opinion on the management of small-bowel obstruction. The topic is limited to small-bowel obstruction secondary to postoperative adhesions. Other causes of small-bowel obstruction are not addressed. We attempt to give readers a concise insight into the evidence available in the English language literature. This paper does not offer a comprehensive review of the topic; rather it highlights some relevant issues and then outlines what role, if any, laparoscopic surgery should play in the management of adhesive small-bowel obstruction. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
43. Colonization and Infection by Helicobacter pylori in Humans.
- Author
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Andersen, Leif Percival
- Subjects
HELICOBACTER pylori ,STOMACH ,HELICOBACTER ,GASTROINTESTINAL system ,ABDOMEN ,ESOPHAGOGASTRIC junction ,GASTRIC fundus ,GASTRIC mucosa ,DIGESTIVE organs ,GASTROENTEROLOGY - Abstract
When Helicobacter pylori arrives in the human stomach, it may penetrate the mucin layer and adhere to the gastric epithelial cells or it may pass through the stomach without colonizing the mucosa. In this paper, the colonization process and the ensuing immunological response will be briefly described. Urease production is necessary for H. pylori to establish a pH-neutral microenvironment around the bacteria. The flagella enable the bacteria to move and the shape of H. pylori makes it possible to penetrate the mucin layer where it comes into contact with the gastric epithelial cells. H. pylori contains several adhesins that enable it to adhere to the epithelial cells. This adherence activates IL-8 which, together with bacterial antigens, attracts polymorphs and monocytes and causes acute gastritis. Antigen-presenting cells activate lymphocytes and other mononuclear cells that are attracted to the inflamed mucosa, causing chronic superficial gastritis and initiating a cytotoxic or an antigen-producing Th response. The infection is established within a few weeks after the primary exposure to H. pylori. After this initial colonization, many chemical, biochemical, and immunologic reactions take place that are of importance in the progress of the infection and the development of disease. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
44. Impact of adhesions in colorectal surgery.
- Author
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Bhardwaj, R. and Parker, M. C.
- Subjects
TISSUE adhesions ,COLON diseases ,SURGICAL complications ,MEDICAL care ,CLINICAL medicine - Abstract
The extent of the problem of adhesions is considerable and poses a significant burden on healthcare systems, the workload of surgeons and the lives of patients. This paper reviews the work undertaken and the associated evidence for the impact of adhesions. It considers the various options and strategies to reduce adhesions alongside the fundamental necessity for good surgical technique. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
45. Die Behandlung der postoperativen Schultersteife nach arthroskopischen Schulteroperationen.
- Author
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Hosseini, H., Agneskirchner, J., and Lobenhoffer, P.
- Abstract
Copyright of Arthroskopie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2006
- Full Text
- View/download PDF
46. Increasing the level of cytoskeletal protein Flightless I reduces adhesion formation in a murine digital flexor tendon model
- Author
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Jackson, Jessica E., Kopecki, Zlatko, Anderson, Peter J., and Cowin, Allison J.
- Published
- 2020
- Full Text
- View/download PDF
47. Circumcision
- Author
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Wald, George, Denniston, George C., editor, Hodges, Frederick M., editor, and Milos, Marilyn Fayre, editor
- Published
- 2010
- Full Text
- View/download PDF
48. Molecular Biology of Flexor Tendon Healing in Relation to Reduction of Tendon Adhesions.
- Author
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Legrand, Anais, Kaufman, Yoav, Long, Chao, and Fox, Paige M.
- Abstract
Tendon injuries are encountered after major and minor hand trauma. Despite meticulous repair technique, adhesion formation can occur, limiting recovery. Although a great deal of progress has been made toward understanding the mechanism of tendon healing and adhesions, clinically applicable solutions to prevent adhesions remain elusive. The goal of this paper is to review the most recent literature relating to the tendon healing and adhesion prevention. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
49. (Near‐) Infrared Drying of Lithium‐Ion Battery Electrodes: Influence of Energy Input on Process Speed and Electrode Adhesion.
- Author
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Altvater, Andreas, Heckmann, Thilo, Eser, Jochen Christoph, Spiegel, Sandro, Scharfer, Philip, and Schabel, Wilhelm
- Subjects
COGNITIVE processing speed ,LITHIUM-ion batteries ,ELECTRODES ,INFRARED radiation ,NEAR infrared radiation ,MASS transfer ,HEAT transfer - Abstract
The drying of electrodes represents a critical process step in the production of lithium‐ion batteries. In this process step, unfavorably adjusted drying conditions can result in deteriorated electrode properties. Furthermore, the process speed is restricted by limited heat and mass transfer in purely convective drying. To counteract those effects, energy input by near‐infrared (NIR) radiation is a promising approach. Herein, analytical considerations are carried out to demonstrate the suitability of infrared radiation with regard to achievable electrode temperatures and drying rates. In an experimental approach, aqueous processed graphite anodes are dried with an NIR module, varying the power and the amount of convection for different experiments. The temperature profiles of the electrodes and the drying rates are measured and analyzed, and the electrodes are subsequently characterized using adhesion measurements. The results obtained show that energy input by NIR radiation during the drying of electrodes can lead to an increased drying speed, electrode temperature during drying, and adhesion force of the dry electrode. These findings indicate that the binder distribution during NIR drying is advantageous in terms of electrode adhesion, compared with convectively dried electrodes produced at comparable drying rates, positioning the process promisingly with regard to high throughput rates. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
50. Laparoscopic Abdomino-perineal Resection Followed by Early Postoperative Acute Small Bowel Obstruction-A Case Report with Review of Literature.
- Author
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VINOTH, M. and JOSHI, ABHIJIT
- Subjects
LITERATURE reviews ,SMALL intestine ,LAPAROSCOPIC surgery ,ABDOMINOPERINEAL resection ,LIQUID films ,RECTAL cancer - Abstract
Abdominoperineal Resection (APR) is the long established therapeutic surgical procedure for cancers of the lower rectum. With the advent of minimal access surgery, APR too has come under its ambit. The large pelvic peritoneal defect and raw area left behind, after dissection are unique to APRs. This report describes the case of a 75-year-old male patient diagnosed with low rectal cancer, who underwent a laparoscopic APR and developed an early post-operative adhesive acute small bowel obstruction. Having failed a trial of conservative management, the same was successfully managed by a re-look laparoscopy. The risk of postoperative adhesions decreases significantly with laparoscopy. APR (whether open or laparoscopic), is a unique operation that causes the formation of a large pelvic raw area, which is very prone to attracting small bowel adhesion/s. The advent of various anti-adhesion barriers (liquid and films) has helped in decreasing the incidence of adhesions. However, in spite of the availability of a wide array of options, there is no consensus among surgeons as to the most optimum agent. Ideally, a tension free closure of the pelvic peritoneal defect formed during APR should be attempted. Failing this, covering of the wide pelvic raw area by a dual mesh or an anti-adhesion barrier agent (fluid or film) or omentopexy have been reported as adhesion preventing manoeuvres. Interceed® promises to be a useful long term adhesion preventing barrier option. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
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