Prevention of adhesions in gynaecological surgery: the 2012 European field guideline

Gynecological Surgery - Tập 9 Số 4 - Trang 365-368 - 2012
Rudy Leon De Wilde1, Hans A.M. Brölmann2, Philippe Koninckx3, Per Lundorff4, A.M. Lower5, Arnaud Wattiez6, Michal Mára7, Markus Wallwiener8
1Pius-Hospital Frauenklinik
2VU University
3Katholieke Universiteit
4Viborg Hospital
5The Womens’ Health Partnership Ltd
6Hôpital de Hautepierre
7Charles University
8University of Heidelberg#TAB#

Tóm tắt

AbstractPostoperative adhesions have become the most common complication of open or laparoscopic abdominal surgery and a source of major concern because of their potentially dramatic consequences. The proposed guideline is the beginning of a major campaign to enhance the awareness of adhesions and to provide surgeons with a reference guide to adhesion prevention adapted to the conditions of their daily practice. The risk of postoperative adhesions should be systematically discussed with any patient scheduled for open or laparoscopic abdominal surgery prior to obtaining her informed consent. Surgeons should adopt a routine adhesion reduction strategy with good surgical technique. Anti-adhesion agents are an additional option, especially in procedures with a high risk of adhesion formation, such as ovarian, endometriosis and tubal surgery and myomectomy. We conclude that good surgical practice is paramount to reduce adhesion formation and that anti-adhesion agents may contribute to adhesion prevention in certain cases.

Từ khóa


Tài liệu tham khảo

Trew G (2004) Consensus in adhesion reduction management. Obstet Gynaecol 6(suppl 2):1–16

DeWilde RL, Trew G (2007) Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position. Part 2—steps to reduce adhesions. Gynecol Surg 4:243–253

Diamond MP, Wexner SD, diZerega GS et al (2012) Adhesion prevention and reduction: current status and future recommendations of a multinationalinter-disciplinary consensus conference. Surg Innov 17:183–188

Robertson D, Lefebvre G, Leyland N et al (2012) Adhesion prevention in gynaecological surgery. J Obstet Gynaecol Can 32:598–608

Hirschelmann A, Tchartchian G, Wallwiener M, Weyhe D, Hackethal A, De Wilde RL (2010) A review of the problematic adhesion prophylaxis in gynaecological surgery. Arch Gynecol Obstet 285(4):1089–1097

Hirschelmann A, Wallwiener CW, Wallwiener M, Weyhe D, Tchartchian G, Hackethal A, De Wilde RL (2012) Is patient Education about adhesions a requirement in abdominopelvic surgery? Geburtsh Frauenheilk 72:299–304

Kraemer B, Birch JC, Birch JV, Petri N, Ahmad U, Marikar D, Wallwiener M, Wallwiener C, Foran A, Rajab TK (2011) Patients’ awareness of postoperative adhesions: results from a multi-centre study and online survey. Arch Gynecol Obstet 283(5):1069–1073

Lower AM, Hawthorn RJ, Clark D, Surgical and Clinical Research (SCAR) Group et al (2004) Adhesion-related readmissions following gynaecological laparoscopy or laparotomy in Scotland: an epidemiological study of 24,046 patients. Hum Reprod 19:1877–1885

Monk BJ, Berman ML, Montz FJ (1994) Adhesions after extensive gynecologic surgery: clinical significance, etiology, and prevention. Am J Obstet Gynecol 170(5 Pt 1):1396–1403

Ellis H, Moran BJ, Thompson JN et al (1999) Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study. Lancet 353:1476–1480

Ellis H (1998) The magnitude of adhesion related problems. Ann Chir Gynaecol 87:9–11

Van Der Krabben AA, Dijkstra FR, Nieuwenhuijzen M et al (2000) Morbidity and mortality of inadvertent enterotomy during adhesiotomy. Br J Surg 87:467–471

Swank DJ, Swank-Bordewijk SC, Hop WC et al (2003) Laparoscopic adhesiolysis in patients with chronic abdominal pain: a blinded randomised controlled multi-centre trial. Lancet 361:1247–1251

Hershlag A, Diamond MP, DeCherney AH (1991) Adhesiolysis. Clin Obstet Gynecol 34:395–402

Mishell DR, Davajan V (1991) Evaluation of the infertile couple. In: Mishell DR Jr, Davajan V, Lobo RA (eds) Infertility contraception and reproductive endocrinology, 3rd edn. Blackwell, Boston, pp 557–570

Wilson MS, Menzies D, Knight AD, Crowe AM (2002) Demonstrating the clinical and cost effectiveness of adhesion reduction strategies. Colorectal Dis 4:355–360

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Gynecological Surgery

Tập 9 Số 4

365-368

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