Ghobrial Stefan, Ott Johannes, Parry John Preston
Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, 1090 Vienna, Austria.
Parryscope and Positive Steps Fertility, Madison, Madison, WI 39110, USA.
J Clin Med. 2023 Mar 15;12(6):2263. doi: 10.3390/jcm12062263.
Postoperative intraabdominal adhesions can occur after more than 90% of gynecologic surgeries. They not only cause chronic pelvic pain and small bowel obstruction, but are also one of the main reasons for infertility. Adhesions are not only a burden for the affected patients, but are also a burden for the healthcare system, since the treatment of adhesion-associated complications costs a considerable amount of money. The gold standard for the diagnosis of adhesions is by laparoscopy, although other methods, such as transvaginal hydro-laparoscopy, are being discussed as better alternatives. Ideally, adhesions are avoided inherently, by operating carefully and by using microsurgical principles. If this is not possible, gel barriers have been shown to be successful in reducing postoperative adhesions.
超过90%的妇科手术后会发生术后腹腔粘连。它们不仅会导致慢性盆腔疼痛和小肠梗阻,也是导致不孕的主要原因之一。粘连不仅给受影响的患者带来负担,也给医疗系统带来负担,因为治疗与粘连相关的并发症需要花费大量资金。粘连诊断的金标准是腹腔镜检查,尽管其他方法,如经阴道水腹腔镜检查,正在作为更好的替代方法进行讨论。理想情况下,通过谨慎操作和运用显微外科原则可从根本上避免粘连。如果无法做到这一点,已证明凝胶屏障在减少术后粘连方面是成功的。