| Prevention of intra-peritoneal adhesions in gynaecological surgery: theory and evidence. | |
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MedLine Citation:
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PMID: 20688570 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Post-operative adhesions are a significant complication of all abdominal surgical procedures. The major strategies for adhesion prevention in gynaecological surgery are focused on the optimization of surgical technique and use of anti-adhesive agents, which fall into two main categories: pharmacological agents and barriers. Surgical technique that minimizes peritoneal trauma can reduce, but cannot prevent post-operative adhesion formation. Various local and systemic drugs that can alter the local inflammatory response, inhibit the coagulation cascade and promote fibrinolysis have been evaluated. Limited data support the administration of post-operative corticosteroids in addition to systemic intra-operative corticosteroids for the prevention of adhesions after gynaecological surgery. None of the remaining pharmacological agents have been found effective for the reduction of post-operative adhesions. Barriers are currently considered the most useful adjuncts, which may reduce adhesion formation. They act by separating the traumatized peritoneal surfaces during the healing period. The separation can be achieved by solid barriers or fluids. There is limited evidence from randomized clinical trials that support the beneficial effect of most of these barrier agents in the prevention of intra-peritoneal adhesions after gynaecological surgery. However, the evidence is not adequate for definite conclusions to be drawn and further research in this field is warranted. |
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Authors:
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G Pados; C A Venetis; K Almaloglou; B C Tarlatzis |
Publication Detail:
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Type: Journal Article; Review Date: 2010-04-27 |
Journal Detail:
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Title: Reproductive biomedicine online Volume: 21 ISSN: 1472-6491 ISO Abbreviation: Reprod. Biomed. Online Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-30 Completed Date: 2010-12-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101122473 Medline TA: Reprod Biomed Online Country: Netherlands |
Other Details:
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Languages: eng Pagination: 290-303 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Peripheral Road, Nea Efkarpia 546 03, Thessaloniki, Greece. padosgyn@hol.gr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenal Cortex Hormones
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pharmacology Anti-Inflammatory Agents, Non-Steroidal / pharmacology Anticoagulants / pharmacology Biocompatible Materials Estrogens / pharmacology Female Gynecologic Surgical Procedures / adverse effects* Histamine Antagonists / pharmacology Humans Models, Biological Peritoneal Diseases / etiology, prevention & control* Polymers Postoperative Complications / etiology, prevention & control* Progesterone / pharmacology Solutions Tissue Adhesions / etiology, prevention & control |
| Chemical | |
Reg. No./Substance:
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0/Adrenal Cortex Hormones; 0/Anti-Inflammatory Agents, Non-Steroidal; 0/Anticoagulants; 0/Biocompatible Materials; 0/Estrogens; 0/Histamine Antagonists; 0/Polymers; 0/Solutions; 57-83-0/Progesterone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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