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