Identifying risk factors for abdominal adhesions: preliminary findings of a prospective study
نویسندگان
چکیده
The objective of this study is to identify relevant risk factors for development abdominal and pelvic adhesions in women based on their prior medical surgical history. primary outcome the presence severity identified at time laparoscopy benign gynecologic disease. This multi-site prospective was approved by local IRB board. All laparoscopic cases performed staff adult patients were eligible inclusion. anticipated size a minimum 1,000 an effort account more rare adhesion-promoting conditions. Cases per standard protocol with entry approach location surgeon preference. Intraoperative photo documentation four quadrants obtained onset each case. Following case, survey form completed (Fig 1) capture data adhesiogenic events, spent adhesiolysis, route entry, location, grade 2), if present. Herein we present interval findings from 2019 until 2021. A total 490 have been collected, overall adhesion incidence 58.98%. most common inflammatory event endometriosis; among endometriosis no surgeries, 61.29%. preceding Cesarean section, 82 having one or Cesareans. Adhesions 87.8% Cesarean, predominantly lower midcentral abdomen requiring average 18.5 minutes adhesiolysis; 44.4% classified as filmy, 33.3% dense, 22.2% cohesive. second laparotomic procedure myomectomy (n=22), which 90.1% had central pelvis. There relatively even distribution types, 24.4minutes adhesiolysis. contrast without surgery (n=10), 80% noted mid These filmy 75% required 14.8 Our preliminary highlight need vigilance regarding intraabdominal adhesions. We anticipate that upon collecting complete dataset, model can be established predicting project has important clinical implications enables provider better counsel rates postoperative development, well guide operative decision-making site entry.View Large Image Figure ViewerDownload Hi-res image Download (PPT)
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ژورنال
عنوان ژورنال: American Journal of Obstetrics and Gynecology
سال: 2022
ISSN: ['1097-6868', '0002-9378', '1085-8709']
DOI: https://doi.org/10.1016/j.ajog.2021.12.048