Surgical Way of Adhesions Formation Prevention

Vladimir M Demidov, PhD D Sci Medicine, Sergei M Demidov, PhD Medicine. Odessa National Medical University, Ukraine


Afteroperation period characterizes by the possible numerous complication developments especially in the case of the intraabdominal surgical interventions. One could observe the immediate response inflammative reaction in case of peritoneum trauma (even mild). Clear that it’s impossible to make an operation even with the help of the modern laparoscopic technique without the peritoneal damage. The peritoneal response reaction starts within the first minutes and hours in the form of the intensive biochemical reaction resulted in the abdominal adhesions formation. The importance of our clinical observation lies in the range that we manage to provide the prophylaxis of the afteroperational adhesions formation in patients during the abdominal operation.
33 patients with acute pancreatitis (AP) and acute cholecystitis (ACh) were operated laparospopically during the last 3 years in the surgical department of the Odessa Municipal Hospital N10. According to their decision, 14 patients received intraabdominal Sandostatin (Novartis Pharma Stein AG, Switzerland) and thioctacid (thioctic or alpha-lipoic acid, Pliva, Croatia) infusions assuming their antiinflammative activities. The rest of the patients (group N2) were operated traditionally without the prophylactic antiadhesive procedures. Theses patients were followed 5-9 days in the hospital, 3, 6 and 12 months during the afteroperational period. Pain intensity and localization as well as abdominal cavity organs ultrasound investigation were performed.
The average pain syndrome intensity 6 hrs after the operation in both groups’ patients was equal to 31.5±5.7 and 34.0±6.2 points, correspondently, that have no statistical difference. 24 hrs after the operation these data were differed insignificantly (19.7±4.8 and 28.1±4.2 points, correspondently; P>0.05). The visceral pain subjective expression 48 hrs and 5 days after the operation in the 1st group patients was 2.5 times less comparing the same index in the 2nd group patient. Analogous observation in these patients 3, 6 and 12 months after the operations revealed the expressed (in 3 till 7 times) less pain expression in the patients of these two groups. Performed ultrasound investigation 6 and 12 months after the operations showed less cases of the afteroperational adhesions formation in patients with intraoperational antiadhesive treatment.
Thus, we report that it is reasonable to provide the prophylactic efforts aimed to prevent the adhesions formation during the laparoscopic operations on the abdominal cavity organs.

Session Number: Poster – Poster Presentations
Program Number: P560
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