Prevention of Postoperative Adhesions

In: Endometriosis · 1995 · pp. 193–200 · doi:10.1007/978-1-4613-8404-5_19 · W92192989
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Peritoneal adhesions can cause bowel obstruction, pelvic pain, and infertility, with their severity inversely related to pregnancy rates.

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This chapter reviews the causes and prevention of postoperative peritoneal adhesions, noting their clinical associations with bowel obstruction, pelvic pain, and infertility and citing classic evidence such as an inverse relationship between adhesion grade and pregnancy rates after tubal reconstruction. It surveys high-level evidence from experimental and clinical studies of various adhesion-prevention strategies, including intraperitoneal agents (e.g., dextran), physical barriers (e.g., absorbable Interceed TC7 and nonabsorbable Gore-Tex), and different surgical modalities and injury mechanisms, while also mentioning reported complications such as recurrent anaphylaxis to intraperitoneal dextran. A major caveat is that the cited literature spans models and contexts (animal uterine horn models, reproductive pelvic surgery, and second-look evaluations), which the chapter implicitly treats as variably comparable and therefore limits direct generalization. Relevance to endometriosis: the chapter explicitly discusses adhesion prevention in the setting of infertility and endometriosis surgery (e.g., use of Interceed TC7 in infertility and endometriosis surgery) and includes citations on adhesions after resection of ovarian endometriomas and laparoscopic management of rectovaginal endometriosis.

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Abstract

Peritoneal adhesions may give rise to bowel obstruction, pelvic pain, and infertility.1–3 The association between peritoneal adhesions and infertility has long been known. It was firmly established in 1979 by Caspi and associates who reported an inverse relationship between the grade of adhesions and pregnancy rates.2 Preview Unable to display preview. Download preview PDF. Similar content being viewed by others

References

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Expanded-polytetrafluoroethylene but not oxidized regenerated cellulose prevents adhesion formation and reformation in a mouse uterine horn model of surgical injury. Fertil Steril 1993;60:550–558. Best CL, Rittenhouse D, Sueldo CE. A comparison of TC7 and 32% dextran 70 for prevention of postoperative adhesions in hamsters. Obstet Gynecol 1991;78:858–860. Best CL, Rittenhouse D, Vasquez C, et al. Evaluation of Interceed(TC7) for reduction of postoperative adhesions in rabbits. Fertil Steril 1992;58:817–20. Pagidas K, Tulandi T. Effects of Ringer’s lactate, Interceed (TC7) and Gore-Tex Surgical Membrane on postsurgical adhesion formation. Fertil Steril 1992;57:199–201. Maxson WS, Herbert CM, Oldfield EL, and Hill GA. Efficacy of a modified oxidized cellulose fabric in the prevention of adhesion formation. Gynecol Obstet Invest 1988;26: 160–165. Editor information Editors and Affiliations Rights and permissions Copyright information © 1995 Springer-Verlag New York, Inc. About this chapter Cite this chapter Luciano, A.A. (1995). Prevention of Postoperative Adhesions. In: Nezhat, C.R., Berger, G.S., Nezhat, F.R., Buttram, V.C., Nezhat, C.H. (eds) Endometriosis. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-8404-5_19 Download citation DOI: https://doi.org/10.1007/978-1-4613-8404-5_19 Publisher Name: Springer, New York, NY Print ISBN: 978-1-4613-8406-9 Online ISBN: 978-1-4613-8404-5 eBook Packages: Springer Book Archive

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