Author:
Savchuk A. Yu.,Polyovyy V. P.
Abstract
Summary. The aim of the study: to evaluate the possibilities of using various parameters as prognostic criteria for the development of adhesion disease (AD) after surgical interventions on the organs of the peritoneal cavity.
Materials and methods. The results of treatment and analysis of clinical data of 102 patients with AD are presented. Patient management, diagnosis and treatment of complications were carried out in accordance with the recommendations of the Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (2018). Clinical and epidemiological parameters, surgical anamnesis were taken into account, statistical analysis was carried out using StudentDV4 and Microsoft Excel computer programs.
The results. It was found that patients with AD had a history of previous surgery, trauma, and purulent-inflammatory pathology. Planned and urgent operations occurred in almost the same number of patients, but urgent interventions prevailed by 7.86%. Most often, it is an intervention on the intestines, half as often – in the gastro-duodeno-pancreatobiliary area, due to abdominal trauma and gynecological pathology. The risk of adhesion formation, according to the data obtained, was reduced by an order of magnitude when using laparoscopic access compared to open.
Conclusions. Adhesion disease is a serious and complex complication of surgical interventions on the organs of the peritoneal cavity, while open access creates the greatest risk for adhesion formation, and the use of a minimally invasive approach reduces the likelihood of AD. In this study, no relationship was established between gender, age, or the specifics of surgical interventions and the occurrence of peritoneal cavity adhesions.
Publisher
Institute of General and Emergency Surgery Named after V.T. Zaitsev NAMS of Ukraine
Reference13 articles.
1. ten Broek RPG, Krielen P, Di Saverio S, et al. 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. World J Emerg Surg. 2018;13:24. https://doi.org/10.1186/s13017-018-0185-2.
2. Catena F, Di Saverio S, Coccolini F, et al. Adhesive small bowel adhesions obstruction: Evolutions in diagnosis, management and prevention. World J Gastrointest Surg. 2016;8(3):222-231. DOI: 10.4240/wjgs.v8.i3.222.
3. Fugazzola P, Coccolini F, Nita Gabriela EN. Validation of peritoneal adhesion index as a standardized classification to universalize peritoneal adhesions definition. J Peritoneum (and other serosal surfaces). 2017;2:61-70.
4. van den Beukel BA, de Ree R, van Leuven S, Bakkum EA, Strik C, van Goor H, ten Broek RPG. Surgical treatment of adhesion-related chronic abdominal and pelvic pain after gynaecological and general surgery: a systematic review and meta-analysis. Hum Reprod Update. 2017;23(3):276- 288. https://doi.org/10.1093/humup.
5. Sisodia V, Sahu SK, Kumar S. Clinical profile of patients with postoperative adhesive intestinal obstruction and its association with intraoperative peritoneal adhesion index. Chirurgia(Bucur) 2016;111:251-8.3.