粘连与粘连松解术：腹腔镜检查的作用
Adhesions and adhesiolysis: the role of laparoscopy.
作者信息
Kavic Stephen M, Kavic Suzanne M
机构信息
Department of Surgery, Yale University School of Medicine, New Haven, Connecticut 06512, USA.
出版信息
JSLS. 2002 Apr-Jun;6(2):99-109.
BACKGROUND
Adhesions commonly result from abdominal and pelvic surgical procedures and may result in intestinal obstruction, infertility, chronic pain, or complicate subsequent operations. Laparoscopy produces less peritoneal trauma than does conventional laparotomy and may result in decreased adhesion formation. We present a review of the available data on laparoscopy and adhesion formation, as well as laparoscopic adhesiolysis. We also review current adjuvant techniques that may be used by practicing laparoscopists to prevent adhesion formation.
DATABASE
A Medline search using "adhesions," "adhesiolysis," and "laparoscopy" as key words was performed for English-language articles. Further references were obtained through cross-referencing the bibliography cited in each work.
DISCUSSION
The majority of studies indicate that laparoscopy may reduce postoperative adhesion formation relative to laparotomy. However, laparoscopy by itself does not appear to eliminate adhesions completely. A variety of adjuvant materials are available to surgeons, and the most recent investigation has demonstrated significant potential for intraperitoneal barriers. Newer technologies continue to evolve and should result in clinically relevant reductions in adhesion formation.
背景
粘连通常由腹部和盆腔手术操作引起，可导致肠梗阻、不孕、慢性疼痛，或使后续手术复杂化。与传统剖腹手术相比，腹腔镜手术对腹膜的创伤较小，可能会减少粘连的形成。我们对腹腔镜手术与粘连形成以及腹腔镜粘连松解术的现有数据进行综述。我们还回顾了执业腹腔镜医师可用于预防粘连形成的当前辅助技术。
数据库
使用“粘连”“粘连松解术”和“腹腔镜检查”作为关键词对英文文章进行了医学文献数据库检索。通过交叉引用每篇文献中引用的参考文献获得了更多参考文献。
讨论
大多数研究表明，与剖腹手术相比，腹腔镜手术可能会减少术后粘连的形成。然而，腹腔镜手术本身似乎并不能完全消除粘连。外科医生可使用多种辅助材料，最新研究表明腹膜内屏障具有显著潜力。新技术不断发展，应能在临床上显著减少粘连的形成。
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