Dehghani Firoozabadi Mohammad Mehdi, Alibakhshi Abbas, Alaeen Hoorieh, Zand Sanaz, Nazemian Ryan, Rahmani Maryam
Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran.
Students' Research Scientific Center, Tehran University of Medical Sciences, Tehran, Iran.
Ann Med Surg (Lond). 2018 Oct 6;36:79-82. doi: 10.1016/j.amsu.2018.09.013. eCollection 2018 Dec.
Intra-abdominal adhesion is one of the most important complications of abdominopelvic surgery. It increases morbidity and mortality for patients. Although laparoscopy is the gold standard of adhesion diagnosis, it can cause visceral damage during the operation. Therefore, surgeons prefer to use non-invasive methods for planning the operation. We designed this study to evaluate transabdominal ultrasonography ( TAU) accuracy for diagnosing Intra-abdominal Adhesions.
MATERIAL & METHODS: This double-blinded cohort study was conducted on 47 patients with previous laparotomy who undergo another surgery. Spontaneous visceral slide (SVS) and induced visceral slide (IVS) were measured during TAU.
The mean age and BMI of 47 patients were 43.21±10.3 and 27.545±5.76. The majority of the patients were female (76%). Mean SVS and IVS in patients with intra-abdominal adhesion were 8.73±1.60 and 44.84±11.60. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of TAU in intra-abdominal diagnosis were 83.33%, 51.72%, 51.72%, 83.33%, 63.83%.
Although TAU is an appropriate method for detecting the intra-abdominal adhesion, it isn't good enough for diagnosing free adhesion area. We recommended further researches with greater sample size and other non-invasive techniques.
腹腔粘连是腹部盆腔手术最重要的并发症之一。它会增加患者的发病率和死亡率。尽管腹腔镜检查是粘连诊断的金标准，但在手术过程中可能会造成内脏损伤。因此，外科医生更倾向于使用非侵入性方法来规划手术。我们设计了这项研究来评估经腹超声检查（TAU）诊断腹腔粘连的准确性。
这项双盲队列研究对47例曾接受剖腹手术且需再次手术的患者进行。在经腹超声检查期间测量自发内脏滑动（SVS）和诱导内脏滑动（IVS）。
47例患者的平均年龄和体重指数分别为43.21±10.3和27.545±5.76。大多数患者为女性（76%）。腹腔粘连患者的平均SVS和IVS分别为8.73±1.60和44.84±11.60。经腹超声检查在腹腔诊断中的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性分别为83.33%、51.72%、51.72%、83.33%、63.83%。
尽管经腹超声检查是检测腹腔粘连的一种合适方法，但对于诊断游离粘连区域还不够理想。我们建议进行更大样本量的进一步研究以及采用其他非侵入性技术。
