Occelli B, Zafrani Y, Narducci F, Bigotte A, Leblanc E, Querleu D
Service de Chirurgie Gynécologique, Hôpital de Valenciennes, avenue de Monaco, BP 479, 59322 Valenciennes Cedex.
J Gynecol Obstet Biol Reprod (Paris). 2004 Apr;33(2):110-8. doi: 10.1016/s0368-2315(04)96409-5.
Advanced cancers of the cervix are treated by external radiotherapy within range limits which depend on the para-aortic ganglion metastases found during surgical staging. The presence of postoperative intraperitoneal adhesions increases the risk of postradical enteritis. The aim of this study is to investigate the efficacy of an anti-adhesive substance (Intergel) undergoing para-aortic lymphadenectomy by laparotomy.
We conduced a prospective, randomized study on 60 pigs divided into 2 groups (with and without Intergel) undergoing para-aortic lymphadenectomy by laparotomy to compare the efficacy of an anti-adhesive substance using an adhesion scoring system based on density and surface area in question.
There was no difference between the 2 groups in terms of duration of surgery, number of ganglia removed, postoperative mortality and per and postoperative morbidity, especially the adhesion process.
Administration of an anti-adhesive substance such as Intergel does not reduce the adhesion process after para-aortic lymphadenectomy in animals. However, perhaps we can not interpret these results because of the too much quantity of anti-adhesive substance for the animal weight, and because of the too precocious control.
晚期宫颈癌通过体外放疗进行治疗,放疗范围取决于手术分期时发现的腹主动脉旁神经节转移情况。术后腹腔粘连的存在会增加根治性肠炎的风险。本研究的目的是探讨一种抗粘连物质(Intergel)在开腹行腹主动脉旁淋巴结清扫术中的疗效。
我们对60头猪进行了一项前瞻性随机研究,将其分为两组(使用Intergel组和未使用Intergel组),通过开腹行腹主动脉旁淋巴结清扫术,采用基于粘连密度和表面积的粘连评分系统比较一种抗粘连物质的疗效。
两组在手术时间、切除神经节数量、术后死亡率以及术后发病率方面,尤其是粘连过程,均无差异。
在动物中,使用Intergel等抗粘连物质并不能减少腹主动脉旁淋巴结清扫术后的粘连过程。然而,由于抗粘连物质的用量相对于动物体重过大,以及控制时间过早,或许我们无法对这些结果进行解读。