Postoperatif peritoneal yapışıklıkların oluşumu ve klinik önemi

Öz

Abdominopelvik cerrahi sonrası oluşan karın içi yapışıklıkların, erken ve geç postoperatif devrede mortalite ve morbidite artışına neden oldukları bilinen bir gerçektir. Karın içi yapışıklıkların, periton veya barsağın serozal yüzeyine travma, yabancı cisim reaksiyonu ve iskemi sonucunda geliştiğine inanılmaktadır. Bu makalede postoperatif peritoneal yapışıklıkların oluşumu ve klinik önemi literatür bilgileri eşliğinde tartışılmıştır.

Anahtar Kelimeler

• Operasyon sonrası, peritoneal yapışıklıklar, patogenez, önleme

Formation and clinical importance of postoperative peritoneal adhesions

Abstract

Abdominal adhesions following abdominopelvic surgical interventions are well-known causes of increased morbidity and mortality at early and late postoperative period. It is suggested that intraabdominal adhesions are thought to be developed secondary to peritoneal or bowel serosal surface trauma, foreign body reaction and ischemia. In present study, development and clinical importance of postoperative peritoneal adhesions are discussed together with literature knowledge.

Keywords

• Postoperative, peritoneal adhesions, pathogenesis, prevention

Kaynakça

1. Bulbuller N, Ilhan YS. Can angiotensin converting enzyme inhibitors prevent postoperative adhesions? J Surg Res 2005;125:94–7.
2. Ellis H. The causes and prevention of intestinal adhesions. Br J Surg 1982;69:241-243.
3. Cheong YC. Peritoneal healing and adhesion formation /ref- ormation. Human Reproduvtive Update 2001;7:556-66.
4. Chiang SC. TNP-470 ınhibits ıntraabdominal adhesion for- mation. J Pediatr Surg 2000;35:189-96.
5. Risberg B. Adhesions: Preventive strategies. Eur J Surg 1997;577:32-9.
6. Raftery A. Regeneration of parietal and visceral peritoneum in the immature animal. Br J Surg 2000;60:969-75.
7. Douvdevani A, Rapoport J, Konfort A, et al. Human perito- neal mesothelial synthesize IL-1 alpha and beta. Kidney Int 1994;46:993-1001.
8. Bachus K, Doty E, Haney A. Differantial effects of interleu- kin-1 alpha,tumor necrozis factor–alpha, indomethacin, hy- drocortisone, and macrophageco-culture on the proferation of human fibroblasts and peritoneal mesothelial cells. J Soc Gynecol Invest 1995;2:636-42.

9. Offner, F.Feictinger, TgF-beta synthesis by human peritoneal mesothelial cells ınduction by interleukin -1. Am J Pathol 1995;148:1679-88.
10. Arici A. Interleukin -8 cconcentration in peritoneal fluid of patient with endometriosis and modulation of interleukin -8 expression in human mesothelial cells. Mol Hum Repr 1996;2:40-5.
11. Dixon CT, Rixford EL. Cytologic response to peritoneal irritation in man: a protective mechanism. Am J Surg 1934;25:504-5.
12. Autio V. The spread of intraperitoneal infection. Acta Chir Scant 1981;91:s98-s99.
13. Gomel V, Urman B, Gürgan T. Pathophysiology of adhe- sion formation and strategies for prevention. J Reprod Med 1996;41:35-41.
14. Drollette CM, Badawy SZA: Pathophysiology of pelvic ad- hesions: modern trends in preventing infertility. J Reprod Med 1992;37:107-121.
15. G, Grobety J, Majino G. Postoperative peritoneal adhesions: a study of mechanism. Am J Pathol 1971;65:117-48.
16. Zerega GS. Biochemical events in peritoneal tissue repair. Eur J Surg 1997;577:10-16.
17. Buckman RF, Woods M, Sargent L. A unifying Pathogenet- ic Mechanism in the etiology of intraperitoneal adhesions. J Surg Res 1996;20:1-5.
18. Knightly J, Agostine D, Cliffton E. The effect of fibrin- olysin and heparin on the formation of peritoneal adhesions Surgery 2002; 52:250-8.
19. Halmdahl L, Risberg B, Beck DE, et al. Adhesions, Patho- genesis and prevention panel-discussion and summary. Eur J Surg 1997;577:56-62.
20. Buckman RJ, Buckman P, Hufnagel H. A physiologic basis for the adhesion free healing of deperitonealized surfaces. J Surg Res 1996;21:67-76.
21. Ellis H, Moran BJ, Thompson JN, et al. Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study. Lancet 1999;353:1476-80.
22. Liakakos T, Thomakos N, Fine PM, et al. Peritoneal adhe- sions: etiology, pathophysiology, and clinical significance. Recent advances in prevention and management. Dig Surg 2001;18:260-73.
23. Menzies D. Postoperatif adhesions: their treatment and rel- evance in clinical practise. Ann R Cool Surg 1995;75:147- 53.
24. Ray NF, Denton WG, Thamer M, et al. Abdominal adhesi- olysis: inpatient care and expenditures in the United States in 1994. J Am Coll Surg 1998;186:1-9.
25. Wilson MS, Hawkswell J, McCloy RF. Natural history of adhesional small bowel obstruction: countingthecost. Br J Surg 1998;85:1294-8.
26. Monk BJ, Berman ML, Montz FJ. Adhesions after extensive gynecologic surgery: clinical significance, etiology, and prevention. Am J Obstet Gynecol 1994;170:1396-1403.
27. Ellis H. The clinical significance of adhesions: focus on in- testinal obstruction. Eur J Surg 1997;22:s5-s9.
28. Menzies D. Postoperative adhesions: their treatment and relevance in clinical practice. Ann R Coll Surg Engl 1993;75:147-53.
29. DeCherney AH, diZerega GS. Clinical problem of intraperi- toneal postsurgical adhesion formation following general surgery and the use of adhesion prevention barriers. Surg Clin North Am 1997;77:671-88.
30. Jeekel H. Cost implications of adhesions as highlighted in a European study. Eur J Surg 1997;579:s43-s5.
31. Ellis H. The cause and prevention of postoperative intra- peritoneal adhesions. Surg Gynecol Obstet 1971;133:497- 511.
32. Tulandi T, Collins JA, Burrows E, et al. Treatment –depen- dent and treatment indepent pregnancy among with periad- nexal adhesions. Am J Obstrect Gynecol 1990;162:354-7.
33. Saravelos H, Li TC, Cooke ID. An analysis of the outcome of microsurgery and laparoscopic adhesiolysisfor infertil- ity. Hum Reprod 1995;109:2887-94.
34. Sutton C, Macdonalds R. Laser laparoscopic adhesiolysis. Lap surgery 1990; 6: 155-9.
35. Soo KC, Davidson T, Parker M, Paterson I, Paterson A. In- testinal obstruction in patients with gynaecological malig- nancies. Ann Acad Med 1988;17:72-5.
36. Menzies D, Ellis H. Intestinal obstruction from adhe- sions--how big is the problem? Ann R Coll Surg Engl 1990;72:60-3.
37. Cunanan RG Jr, Courey NG, Lippes J. Laparoscopic find- ings in patients with pelvic pain. Am J Obstet Gynecol 1983;146:589-91.