Obstrucción intestinal secundaria a formación de adherencias postoperatorias en cirugía abdominal. Revisión de la literatura

Published on Jul 1, 2015in Cirugia Y Cirujanos0.264
· DOI :10.1016/J.CIRCIR.2015.05.024
José Manuel Correa-Rovelo4
Estimated H-index: 4
Guadalupe Cleva Villanueva-López2
Estimated H-index: 2
+ 2 AuthorsAlejandro Díaz-Girón-Gidi2
Estimated H-index: 2
(Universidad La Salle)
Resumen El desarrollo de oclusion intestinal despues de la cirugia abdominal superior e inferior es parte de la vida cotidiana de cada cirujano. Existen pocos estudios de calidad que permiten una apreciacion de la frecuencia de la oclusion intestinal postoperatoria. Las adherencias postoperatorias son causa de una considerable morbilidad y su prevencion se puede considerar un problema de salud publica. En Mexico, no hay ninguna recomendacion validada (que en relacion al trato gentil a los tejidos, por lo obvio no se menciona) sobre la prevencion de las adherencias ni, mas en particular, en relacion con el uso de una variedad de productos comerciales antiadhesion que han sido comercializados durante al menos una decada. Las adherencias intraperitoneales se desarrollan entre las superficies sin peritoneo de los organos abdominales, mesenterios, y la pared abdominal; el sitio mas comun de formacion de adherencias es entre el epiplon mayor, y la pared abdominal anterior. A pesar de la frecuencia de adherencias y sus consecuencias directas e indirectas, solo hay una recomendacion publicada (a partir de la literatura ginecologica), en relacion con la prevencion de adherencias peritoneales. Respecto a la cirugia colorrectal se realizan mas de 250,000 resecciones colorrectales anualmente en los Estados Unidos, y del 24 a 35% de ellos desarrollaran una complicacion. La carga clinica y economica de estas complicaciones es enorme, y las cirugias colorrectales se han puesto de relieve especificamente como un punto de morbilidad quirurgica potencialmente prevenibles.
#1Juan M. Zavala-Rodriguez (IPN: Instituto Politécnico Nacional)H-Index: 1
#2José Manuel Correa Rovelo (IPN: Instituto Politécnico Nacional)H-Index: 1
Last. Cleva Villanueva (IPN: Instituto Politécnico Nacional)H-Index: 9
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Abstract Background Surgically induced adhesions complicate up to 100% of abdominal surgeries. Food and Drug Administration–approved treatments are generally not only less effective than desired but they also have major contraindications. Oxychlorine species, including chlorine dioxide (ClO 2 ), suppress scar formation in infected wounds without affecting keratinocytes while reducing fibroblast proliferation. The aim of the present study was to evaluate the effect of oxychlorine solutions contai...
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Background Adhesive small bowel obstruction (ASBO) is an important cause of hospital admission, is associated with significant morbidity and mortality, and therefore is a substantial burden for healthcare systems worldwide. Icodextrin 4% solution (Adept, Shire Pharmaceuticals, UK) is a high-molecular-weight a-1,4 glucose polymer approved in Europe for use as intraoperative lavage and postoperative instillation to reduce the occurrence of post-surgery intra-abdominal adhesions. The present clinic...
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#1Christos IavazzoH-Index: 22
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Background The median laparotomy is frequently used by abdominal surgeons to gain rapid and wide access to the abdominal cavity with minimal damage to nerves, vascular structures and muscles of the abdominal wall. However, incisional hernia remains the most common complication after median laparotomy, with reported incidences varying between 2-20%. Recent clinical and experimental data showed a continuous suture technique with many small tissue bites in the aponeurosis only, is possibly more eff...
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#1Johnna Schölin (Sahlgrenska University Hospital)H-Index: 1
#2M. Buunen (EUR: Erasmus University Rotterdam)H-Index: 6
Last. Eva Haglind (Sahlgrenska University Hospital)H-Index: 44
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Background Postoperative bowel obstruction caused by intra-abdominal adhesions occurs after all types of abdominal surgery. It has been suggested that the laparoscopic technique should reduce the risk for adhesion formation and thus for postoperative bowel obstruction. This study was designed to compare the incidence of bowel obstruction in a randomized trial where laparoscopic and open resection for colon cancer was compared.
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#1Bobby Vm Dasari (Wellington Management Company)H-Index: 1
#2Damian McKay ('QUB': Queen's University Belfast)H-Index: 2
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Background Crohn's disease (CD) is a chronic inflammatory bowel disease that most commonly involves the terminal ileum and colon (55 percent). Surgical treatment is required in approximately 70 percent of patients. Multiple procedures and repeat operations are required in 30 - 70 percent of all patients (Duepree 2002) but the disease remains incurable. Laparoscopy has gained wide acceptance in gastrointestinal surgery with potential advantages of faster return to normal activity and diet, reduce...
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#1G. W. Taylor (St James's University Hospital)H-Index: 4
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Background: This study investigated adhesive intestinal obstruction (AIO) and incisional hernia (IH) in patients undergoing laparoscopically assisted and open surgery for colorectal cancer. Methods: In a case-note review of patients randomized to the Medical Research Council's Conventional versus Laparoscopic-Assisted Surgery In Colorectal Cancer (CLASICC) trial, primary and key secondary endpoints were AIO and IH admission rates respectively. Results: Of 411 patients, 11 were admitted for AIO: ...
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#1Daniel MillbournH-Index: 7
#2Yucel CengizH-Index: 12
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HYPOTHESIS: In midline incisions closed with a single-layer running suture, the rate of wound complications is lower when a suture length to wound length ratio of at least 4 is accomplished with a ...
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#1Terry T. W. Leung (U of C: University of Calgary)H-Index: 2
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Introduction:Appendicitis is a common problem that is typically treated with an appendectomy. Following abdominal surgery, adhesions may form and may cause a subsequent small bowel obstruction (SBO). The purpose of our study was to determine the rate of post-appendectomy SBO in an adult population,
75 CitationsSource
#1Senthil Kumar (The Queen's Medical Center)H-Index: 22
#2Peng F Wong (University Hospital of North Tees)H-Index: 2
Last. David Leaper (Cardiff University)H-Index: 48
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Intra-abdominal adhesions are common and challenge patients, surgeons and other healthcare providers. They are potentially preventable and several agents that act as barriers between adjacent peritoneal surfaces have been evaluated for prophylaxis. Efficacy, judged by systematic reviews, has only been undertaken in gynaecological surgery.
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Cited By8
#1Dan Wang (CDUTCM: Chengdu University of Traditional Chinese Medicine)H-Index: 2
#2Rong Zhao (CDUTCM: Chengdu University of Traditional Chinese Medicine)H-Index: 2
Last. Chunjie Wu (CDUTCM: Chengdu University of Traditional Chinese Medicine)H-Index: 13
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OBJECTIVES Postoperative intestinal obstruction is a common postoperative complication with typical symptoms of abdominal pain, vomiting, abdominal distension and constipation. The principal aim of this paper is to provide a full-scale review on the categories and characteristics of postoperative intestinal obstruction, pathophysiology, effects and detailed mechanisms of compounds and monomers from traditional Chinese medicine for treating postoperative intestinal obstruction. Moreover, the poss...
#2Catherine Bennett (University of Adelaide)H-Index: 4
Last. Peter-John Wormald (University of Adelaide)H-Index: 77
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INTRODUCTION Adhesions are often considered to be an inevitable consequence of abdominal and pelvic surgery, jeopardizing the medium and long-term success of these procedures. Numerous strategies have been tested to reduce adhesion formation, however, to date, no surgical or medical therapeutic approaches have been successful in its prevention. This study demonstrates the safety and efficacy of Chitogel with Deferiprone and/or antibacterial Gallium Protoporphyrin in different concentrations in p...
#1Anuar Armando Idrobo (University of Valle)
#2Beatriz Eugenia Bastidas (University of Cauca)
Last. Ángela María Merchán Galvis (University of Cauca)
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#1Zhongyong Wu (HMU: Hainan Medical University)
Last. Ming Lin (HMU: Hainan Medical University)
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BACKGROUND: As one of the complications after abdominal operation, early postoperative inflammatory small bowel obstruction (EPISBO) is a great trouble for many patients. The use of somatostatin in treating this disease had been widely reported, but its efficacy and safety were controversial. Therefore, the present research carried out a systematic review of the clinical efficacy and safety of somatostatin in treating EPISBO. METHODS: Computer retrieval was conducted in foreign databases (includ...
#1Jia Wang (Capital Medical University)H-Index: 2
#2Kai Le (PKU: Peking University)H-Index: 1
Last. Bin Zhu (Capital Medical University)H-Index: 6
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Platelet-rich fibrin (PRF) was prepared from the blood of BALB/C inbred mice to explore potential effects on postoperative intestinal adhesion. A murine model of intestinal adhesion characterized by abdominal wall defect/and cecum damage was established by scraping caecum serosa and cutting peritoneum and muscles in the abdominal wall. The wound was covered with PRF (group A), sodium hyaluronate (group B), or left alone (blank control; group C). All animals were monitored for 28 days. The incide...
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Background Postoperative adhesions (POAs) causing mechanical bowel obstruction is a challenging problem for children who underwent prior abdominal surgeries. Unlike in adults, the role of conservative management remains controversial and children tend to require re-operation. However, despite the longer lifetime risk inherent to the pediatric population, studies are still lacking to come up with guidelines on diagnosis and management. This study aimed to review the profiles and outcomes of patie...
#1Nicolás Ayala Servín (Universidad Nacional de Asunción)
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Background: Intestinal occlusion is the persistent arrest of intestinal transit, hinders movement towards distal sections. Adherence secondary to surgeries, the most frequent cause, collaborates in internal hernia formation in 4%. Need for surgical intervention is 6.4-10%. Case Report: Woman, 76 years old, 24 hours of evolution of generalized abdominal pain, due to crisis. Stopping 4-day and gas leak, 24 hours. Sigmoidostomy by CA of Sigmoid Colon. Physical examination: soft abdomen, depressant,...
#1Sheng Li (Southern Medical University)H-Index: 1
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Last. Xue-Qing Yao (Southern Medical University)H-Index: 2
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Background and aims Abdominal cocoon (AC) is a rare abdominal disease with nonspecific clinical features, and it is difficult to be diagnosed before operation and hard to be treated in clinical practice. The aim of this study is to investigate the diagnosis and treatment of AC.
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