بسم الله الرحمن الرحیم. Review Prevention of postoperative peritoneal adhesions: a review of the literature. The American Journal of Surgery Vol 201, No 1, January 2011 Dr. Somayeh Fallahzadeh. Patients undergoing laparotomy for various reasons have
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The American Journal of Surgery
Vol 201, No 1, January 2011
Dr. Somayeh Fallahzadeh
a 90% risk of developing intraperitoneal adhesions.
the incidence of re-admissions directly related to adhesions
varies from 5% to 20%.
It is estimated that in the UnitedStates there are 117 hospitalizations for adhesion-relatedproblems per 100,000 people and the total cost for hospital
and surgeon expenditures is about $1.3 billion.
In someEuropean countries the direct medical costs for adhesionrelated
problems were more than the surgical expenditurefor gastric cancer and almost as much as for rectal cancer.
age younger than 60 years,
previous laparotomy within 5 years,
penetrating abdominal trauma, especially gunshot wounds.
age younger than 40years,
the presence of matted adhesions,
surgical complications during the surgical management of the first episode
Intraoperative techniques such as:
open vs laparoscopic surgery
7.1% in open versus .2% in laparoscopic cholecystectomies,
9.5% in open versus 4.3% in laparoscopic colectomy,
15.6% in open versus 0% in laparoscopic total abdominal hysterectomy,
23.9% in open versus 0% in laparoscopic adnexal surgery
Only in appendectomies there was no difference between the 2 techniques
the damaged serosal surfaces for the first few critical days
allow separate healing of the injured surfaces and may help in the prevention of adhesion formation.
Mechanical barriers include:
fluid barrier agents
showed its effectiveness, a larger-scale study was stopped owing to a lack of efficacy.31