Neagoe Octavian C, Ionica Mihaela, Mazilu Octavian
First Department of Surgery, Second Discipline of Surgical Semiology and Medical and Surgical Oncology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
J Int Med Res. 2018 Jan;46(1):504-510. doi: 10.1177/0300060517727694. Epub 2017 Aug 31.
Objective To evaluate the efficacy of methylene blue in preventing recurrent symptomatic postoperative adhesions. Methods Patients with a history of >2 surgeries for intra-abdominal adhesion-related complications were selected for this study. Adhesiolysis surgery was subsequently performed using administration of 1% methylene blue. The follow-up period was 28.5 ± 11.1 months. Results Data were available from 20 patients (seven men and 13 women) whose mean ± SD age was 51.2 ± 11.4 years. Adhesions took longer to become symptomatic after the first abdominal surgery when the initial pathology was malignant compared with benign. However, the recurrence of adhesions after a previous adhesiolysis surgery had a similar time onset regardless of the initial disease. Following adhesiolysis surgery with methylene blue, the majority of patients did not present with symptoms associated with adhesion complications (i.e., chronic abdominal pain, bowel obstruction) for the length of the follow-up period. Conclusions The use of methylene blue during adhesiolysis surgery appears to reduce the recurrence of adhesion-related symptoms, suggesting a beneficial effect in the prevention of adhesion formation.
目的 评估亚甲蓝预防术后复发性症状性粘连的疗效。方法 本研究选取有2次以上因腹腔粘连相关并发症进行手术史的患者。随后使用1%亚甲蓝进行粘连松解手术。随访期为28.5±11.1个月。结果 20例患者（7例男性和13例女性）的数据可用，其平均年龄±标准差为51.2±11.4岁。与良性病变相比，初次病理为恶性时，首次腹部手术后粘连出现症状的时间更长。然而，无论初始疾病如何，既往粘连松解手术后粘连复发的起始时间相似。使用亚甲蓝进行粘连松解手术后，大多数患者在随访期内未出现与粘连并发症相关的症状（即慢性腹痛、肠梗阻）。结论 在粘连松解手术中使用亚甲蓝似乎可减少粘连相关症状的复发，提示其在预防粘连形成方面具有有益作用。
