Prevention of peritoneal adhesions after gynecological surgery: a systematic review
Uloženo v:
| Název: | Prevention of peritoneal adhesions after gynecological surgery: a systematic review |
|---|---|
| Autoři: | Sebastian D. Schaefer, Ibrahim Alkatout, Nadja Dornhoefer, Joerg Herrmann, Ruediger Klapdor, Ivo Meinhold-Heerlein, Jozsef Meszaros, Alexander Mustea, Peter Oppelt, Markus Wallwiener, Bernhard Kraemer |
| Zdroj: | Arch Gynecol Obstet |
| Informace o vydavateli: | Springer Science and Business Media LLC, 2024. |
| Rok vydání: | 2024 |
| Témata: | ddc:610, Tissue Adhesions, Review, Peritoneal Diseases, 03 medical and health sciences, Gynecologic Surgical Procedures, Postoperative Complications, 0302 clinical medicine, Second-Look Surgery, Humans, Female, Female [MeSH], Pelvic pain, Second-Look Surgery [MeSH], Peritoneal Diseases/etiology [MeSH], Adhesion prevention, Humans [MeSH], Peritoneal Diseases/prevention, Adhesion barrier, Tissue Adhesions/prevention, Randomized Controlled Trials as Topic [MeSH], Gynecologic Surgical Procedures/adverse effects [MeSH], Postoperative Complications/prevention, Peritoneal adhesions, Postoperative Complications/etiology [MeSH], Second-look surgery, Tissue Adhesions/etiology [MeSH], Randomized Controlled Trials as Topic |
| Popis: | Importance The formation of adhesions after gynecological surgery not only has detrimental impacts on those affected, including pain, obstruction, and infertility, but also imposes a high economic burden on healthcare systems worldwide. Objective The aim of this review was to evaluate the adhesion prevention potential of all currently available adhesion barriers for gynecological surgery. Evidence acquisition We systematically searched MEDLINE and CENTRAL databases for randomized controlled trials (RCTs) on the use of adhesion barriers as compared with peritoneal irrigation or no treatment in gynecological surgery. Only RCTs with second-look surgery to evaluate adhesions in the pelvic/abdominal (but not intrauterine) cavity were included. Results We included 45 RCTs with a total of 4,120 patients examining a total of 10 unique types of barriers in second-look gynecological surgery. While RCTs on oxidized regenerated cellulose (significant improvement in 6 of 14 trials), polyethylene glycol with/without other agents (4/10), hyaluronic acid and hyaluronate + carboxymethylcellulose (7/10), icodextrin (1/3), dextran (0/3), fibrin-containing agents (1/2), expanded polytetrafluoroethylene (1/1), N,O-carboxymethylchitosan (0/1), and modified starch (1/1) overall showed inconsistent findings, results for expanded polytetrafluoroethylene, hyaluronic acid, and modified starch yielded the greatest improvements regarding adhesion reduction at 75%, 0–67%, and 85%, respectively. Conclusions and relevance Best results for adhesion prevention were reported after applying Gore-Tex Surgical Membrane, hyaluronic acid, and 4DryField®. As Gore-Tex Surgical Membrane is nonabsorbable, it is associated with a greater risk of new adhesion formation due to second-look surgery to remove the product. 4DryField® yielded the greatest improvement in adhesion score compared to all other barrier agents (85%). For better comparability, future studies should use standardized scores and put more emphasis on patient-reported outcome measures, such as pain and infertility. |
| Druh dokumentu: | Article Other literature type |
| Popis souboru: | application/pdf |
| Jazyk: | English |
| ISSN: | 1432-0711 |
| DOI: | 10.1007/s00404-024-07584-1 |
| DOI: | 10.15496/publikation-101060 |
| DOI: | 10.25673/118320 |
| Přístupová URL adresa: | https://pubmed.ncbi.nlm.nih.gov/38878233 https://repository.publisso.de/resource/frl:6501981 |
| Rights: | CC BY |
| Přístupové číslo: | edsair.doi.dedup.....d19d2ad13ac456d0c71265a70b37b45d |
| Databáze: | OpenAIRE |
Full Text Finder 
Nájsť tento článok vo Web of Science Buďte první, kdo okomentuje tento záznam!