Department of Obstetrics and Gynecology, Polyclinique, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France.
Am J Obstet Gynecol. 2010 Aug;203(2):111.e1-3. doi: 10.1016/j.ajog.2010.03.031.
The objective of the study was the laparoscopic evaluation of the incidence of intraabdominal adhesions related to prior abdominal surgery.
This was a prospective monocentric study including a continuous series of 1000 gynecologic laparoscopic procedures. Data were collected on history of abdominal surgery. A precise initial description of intraoperative adhesions was performed.
Six hundred thirty-seven of the 1000 procedures (63.7%) were performed in patients with a history of 1 or more than 1 abdominal surgery. Intraoperative adhesions were found in 211 of the 1000 subjects (21.10%). Fifty-nine of the 211 cases (28%) involved bowel loops. The prior indication for surgery did not seem to influence adhesion formation. The rate of intestinal adhesions significantly increased with the number of prior abdominal surgeries. The rate of intestinal adhesions was significantly higher in cases of prior midline incisions in comparison with the other incisions.
Extensive preoperative knowledge of prior surgery is essential to evaluate the risk of adhesion formation.
本研究的目的是腹腔镜评估与既往腹部手术相关的腹腔内粘连的发生率。
这是一项前瞻性单中心研究，包括连续 1000 例妇科腹腔镜手术。收集了腹部手术史的数据。对术中粘连进行了精确的初步描述。
1000 例手术中有 637 例（63.7%）为既往有 1 次或多次腹部手术史的患者。1000 例患者中有 211 例（21.10%）发现术中粘连。59 例（28%）涉及肠袢。既往手术的指征似乎并不影响粘连的形成。肠粘连的发生率随着既往腹部手术次数的增加而显著增加。与其他切口相比，既往中线切口的肠粘连发生率明显更高。
广泛了解既往手术史对于评估粘连形成的风险至关重要。
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