Adezyon Oluşumu Ve Önlenmesi

In: \n Volume: 13, Issue: 3\n \n · 1996 · vol. 13(3) · doi:10.5835/jecm.v13i3.688 · W1544122099
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This paper reviews the pathophysiology of peritoneal adhesions, identifying them as frequent sequelae of surgery or inflammatory processes such as infection and endometriosis. The authors explain that adhesion formation results from factors that impede normal fibrinolytic activity, including trauma, ischemia, foreign body reactions, and residual disease, which lead to excessive fibrin deposition. While meticulous surgical technique remains the primary method for prevention, the text notes that this approach alone may be insufficient, leading many surgeons to utilize adjuvant modalities to mitigate risks like infertility, chronic pelvic pain, and intestinal obstruction. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Adhesion Formation and PreventionAdhesions are the sequelae occuring frequently following surgery or inflammatory process such as infection and endometriosis as the variations of normal wound healing. Adhesion formation depends largely upon the factors which impede the fibrinolytic activity of the peritoneum such as trauma, ischemia, foreign body reaction, infection and residual endo-metriosis and factors causing excessive fibrin deposition.Prevention of adhesion formation is an important isseue for surgeons, especially for those dealing with reproductive surgery, cause they might be responsible for intestinal obstruc¬tion, infertility, chronic pelvic pain, ureteral obstruction, voiding dysfunction and the sur¬geon may have difficulty in performing a subsequent operation.For the time being, an appropriate and meticolous surgical approach continues to be the key for the prevention of adhesion formation however, proper surgical approach alone may not be enough for this purpose. As a matter of fact, many surgeons have aldeady been utilizing adjuvant modalites in order to prevent adhesion formation.Adezyonlar sıklıkla cerrahiyi ya da enfeksiyon ve endometriozis gibi iltihabi süreci takiben normal yara iyileşmesinin varyasyonlan olarak ortaya çıkan sekellerdir. Adezyon oluşumu büyük ölçüde travma, iskemi, yabancı cisim reaksiyonu, enfeksiyon ve rezidü endometrio¬zis gibi peritonun fibrinolitik aktivitesini engelleyen ve aşırı fibrin birikimine sebep olan faktörlere bağlıdır.Adezyon oluşumunun önlenmesi; intestinal obstrüksiyon, infertilite, kronik pelvik ağrı, disparoni, ureteral obstrüksiyon, mesane disfonksiyonu ve daha sonraki olası bir ame¬liyatı güçleştirdiklerinden dolayı cerrahlar için, özellikle reprodüktif cerrahi ile uğraşanlar için önemli bir sorundur.Şimdilik, uygun ve titiz bir cerrahi yaklaşım adezyon oluşumunun önlenmesinin anahtarı olmaya devam etmektedir. Ancak, uygun cerrahi yaklaşım bu amaç için yeterli olmayabilir Pratikte, çoğu cerrah adezyon oluşumunu önlemek için değişik adjuvan tedavi modalitelerini kullanmaktadırlar.
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Adezyon Oluşumu Ve Önlenmesi Abstract Adhesion Formation and Prevention Adhesions are the sequelae occuring frequently following surgery or inflammatory process such as infection and endometriosis as the variations of normal wound healing. Adhesion formation depends largely upon the factors which impede the fibrinolytic activity of the peritoneum such as trauma, ischemia, foreign body reaction, infection and residual endo-metriosis and factors causing excessive fibrin deposition. Prevention of adhesion formation is an important isseue for surgeons, especially for those dealing with reproductive surgery, cause they might be responsible for intestinal obstruc¬tion, infertility, chronic pelvic pain, ureteral obstruction, voiding dysfunction and the sur¬geon may have difficulty in performing a subsequent operation. For the time being, an appropriate and meticolous surgical approach continues to be the key for the prevention of adhesion formation however, proper surgical approach alone may not be enough for this purpose. As a matter of fact, many surgeons have aldeady been utilizing adjuvant modalites in order to prevent adhesion formation. Adezyonlar sıklıkla cerrahiyi ya da enfeksiyon ve endometriozis gibi iltihabi süreci takiben normal yara iyileşmesinin varyasyonlan olarak ortaya çıkan sekellerdir. Adezyon oluşumu büyük ölçüde travma, iskemi, yabancı cisim reaksiyonu, enfeksiyon ve rezidü endometrio¬zis gibi peritonun fibrinolitik aktivitesini engelleyen ve aşırı fibrin birikimine sebep olan faktörlere bağlıdır. Adezyon oluşumunun önlenmesi; intestinal obstrüksiyon, infertilite, kronik pelvik ağrı, disparoni, ureteral obstrüksiyon, mesane disfonksiyonu ve daha sonraki olası bir ame¬liyatı güçleştirdiklerinden dolayı cerrahlar için, özellikle reprodüktif cerrahi ile uğraşanlar için önemli bir sorundur. Şimdilik, uygun ve titiz bir cerrahi yaklaşım adezyon oluşumunun önlenmesinin anahtarı olmaya devam etmektedir. Ancak, uygun cerrahi yaklaşım bu amaç için yeterli olmayabilir Pratikte, çoğu cerrah adezyon oluşumunu önlemek için değişik adjuvan tedavi modalitelerini kullanmaktadırlar. Keywords

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endometriosischronic_pelvic_paininfertility

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