Department of Surgery, South Auckland Clinical School, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
World J Surg. 2010 Apr;34(4):704-20. doi: 10.1007/s00268-009-0382-y.
The peritoneum is a bilayer serous membrane that lines the abdominal cavity. We present a review of peritoneal structure and physiology, with a focus on the peritoneal inflammatory response to surgical injury and its clinical implications.
We conducted a nonsystematic clinical review. A search of the Ovid MEDLINE database from 1950 through January 2009 was performed using the following search terms: peritoneum, adhesions, cytokine, inflammation, and surgery.
The peritoneum is a metabolically active organ, responding to insult through a complex array of immunologic and inflammatory cascades. This response increases with the duration and extent of injury and is central to the concept of surgical stress, manifesting via a combination of systemic effects, and local neural pathways via the neuro-immuno-humoral axis. There may be a decreased systemic inflammatory response after minimally invasive surgery; however, it is unclear whether this is due to a reduced local peritoneal reaction.
Interventions that dampen the peritoneal response and/or block the neuro-immuno-humoral pathway should be further investigated as possible avenues of enhancing recovery after surgery, and reducing postoperative complications.
腹膜是衬于腹腔的双层浆膜。本文复习腹膜的结构和生理学，重点阐述腹膜对手术损伤的炎症反应及其临床意义。
我们进行了非系统性临床复习。在 Ovid MEDLINE 数据库中以“腹膜、粘连、细胞因子、炎症和手术”为检索词，对 1950 年至 2009 年 1 月的资料进行检索。
腹膜是一个代谢活跃的器官，通过一系列复杂的免疫和炎症级联反应对损伤作出应答。这种反应的强度与损伤的持续时间和范围相关，是外科应激概念的核心，通过全身效应和通过神经-免疫-体液轴的局部神经途径表现出来。微创手术后可能有全身炎症反应的降低；但是，尚不清楚其是否由于腹膜局部反应的减少。
能抑制腹膜反应和/或阻断神经-免疫-体液途径的干预措施，可能为促进手术后恢复和减少术后并发症提供新的途径。
