Clinical Ophthalmology.
People Policies Reception of articles Other

Anti-adhesion barriers in operative gynecology

Abstract

DOI: 10.32364/2618-8430-2024-7-2-9

O.V. Gudz'1, A.N. Sulima1, I.S. Glazkov1,2, Z.S. Rumyantseva1, O.P. Miklin1, P.A. Ermachkova1

1V.I. Vernadskiy Crimean State University, Simferopol, Russian Federation

2Simferopol Clinical Maternity Hospital No. 2, Simferopol, Russian Federation

This paper provides a comprehensive study and detailed description of the state-of-the-art of the issue of postoperative adhesions, methods to prevent this complication, and factors that contribute to reducing the risk of adhesions. Adhesions are one of the most common complications of surgical interventions. Abdominal and pelvic surgery can provoke chronic pain, infertility, intestinal obstruction, and other complications. Despite the availability and active use of high-tech medical equipment, adhesions can complicate every surgical procedure. Extensive research has now led to a better understanding of the process of adhesion formation; cellular hypoxia is hypothesized to play a crucial role. A deeper understanding of the factors that provoke adhesions will improve technologies and the development of novel methods of prevention and treatment of adhesions. This will result in a clinically relevant improvement of current approaches employed to prevent postoperative adhesions. The gold standard for the prevention of adhesions is a qualified surgical technique and care to minimize tissue trauma, particularly to the peritoneum. In the future, drugs for the prevention of adhesions and measures to reduce their severity will become increasingly important.

Keywords: adhesions, anti-adhesion barriers, laparoscopy, gynecology, prevention, postoperative adhesions.

For citation: Gudz' O.V., Sulima A.N., Glazkov I.S., Rumyantseva Z.S., Miklin O.P., Ermachkova P.A. Anti-adhesion barriers in operative gynecology. Russian Journal of Woman and Child Health. 2024;7(2):144–149 (in Russ.). DOI: 10.32364/2618-8430-2024-7-2-9.

ABOUT THE AUTHORS:

Oksana V. Gudz' — assistant of the Department of Obstetrics, Gynecology, and Perinatology No. 1 of the S.I. Georgievsky Medical Institute, V.I. Vernadskiy Crimean State University; 5/7, Lenin Blvd., Simferopol, 295051, Russian Federation; ORCID iD 0000-0002-48881-6792.

Anna N. Sulima — Dr. Sc. (Med.), professor of the Department of Obstetrics, Gynecology, and Perinatology No. 1 of the S.I. Georgievsky Medical Institute, V.I. Vernadskiy Crimean State University; 5/7, Lenin Blvd., Simferopol, 295051, Russian Federation; ORCID iD 0000-0002-2671-6985.

Ilya S. Glazkov — Dr. Sc. (Med.), professor of the Department of Obstetrics, Gynecology, and Perinatology No. 1 of the S.I. Georgievsky Medical Institute, V.I. Vernadskiy Crimean State University; 5/7, Lenin Blvd., Simferopol, 295051, Russian Federation; Head Doctor, Simferopol Clinical Maternity Hospital No. 2; 30, 60 let Oktyabrya str., Simferopol, 295024, Russian Federation; ORCID iD 0000-0002-7432-5161.

Zoya S. Rumyantseva — C. Sc. (Med.), Associate Professor, Head of the Department of Obstetrics, Gynecology, and Perinatology No. 1 of the S.I. Georgievsky Medical Institute, V.I. Vernadskiy Crimean State University; 5/7, Lenin Blvd., Simferopol, 295051, Russian Federation; ORCID iD 0000-0002-1711-0210.

Oleg P. Miklin — C. Sc. (Med.), associate professor of the Department of Obstetrics, Gynecology, and Perinatology No. 1 of the S.I. Georgievsky Medical Institute, V.I. Vernadskiy Crimean State University; 5/7, Lenin Blvd., Simferopol, 295051, Russian Federation; ORCID iD 0000-0002-4863-602X.

Polina A. Ermachkova — student of the Department of Obstetrics, Gynecology, and Perinatology No. 1 of the S.I. Georgievsky Medical Institute, V.I. Vernadskiy Crimean State University; 5/7, Lenin Blvd., Simferopol, 295051, Russian Federation; ORCID iD 0000-0002-8782-4007.

Contact information: Anna N. Sulima, e-mail: gsulima@yandex.ru.

Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.

There is no conflict of interest.

Received 26.12.2023.

Revised 26.01.2024.

Accepted 20.02.2024.

References
1. Lower A.M., Hawthorn R.J., Clark D. et al. Adhesion-related readmissions following gynaecological laparoscopy or laparotomy in Scotland: an epidemiological study of 24 046 patients. Hum Reprod. 2004;19(8):1877–1885. DOI: 10.1093/humrep/deh321. 2. Маилова К.С., Осипова А.А., Корона Р. и др. Факторы, влияющие на образование спаек при лапароскопических операциях. Актуальные проблемы медицины. 2012;4:123.Mailova K.S., Osipova A.A., Korona R. et al. Factors affecting adhesion formation in laparoscopic surgery. Сhallenges in modern medicine. 2012;4:123 (in Russ.). 3. Минаева Е.А. Интраоперационный метод лечения и профилактики спаечной болезни малого таза у пациенток с трубно-перитонеальным бесплодием: атореф. дис. … канд. мед. наук. Волгоград; 2015.Minaeva E.A. Intraoperative method of treatment and prevention of pelvic adhesions in patients with tubal-peritoneal infertility: thesis. Volgograd; 2015 (in Russ.). 4. Маилова К.С. Факторы риска и профилактика спаечного процесса при лапароскопии в гинекологии: автореф. дис. … канд. мед. наук, М.; 2012.Mailova K.S. Risk factors and prevention of adhesions during laparoscopy in gynecology: thesis. M.; 2012 (in Russ.). 5. Мацынин А.Н., Шаганов П.Ф., Гребельная Н.В. Cтруктура причин спаечного процесса органов малого таза при гинекологической патологии у женщин репродуктивного возраста. Медико-социальные проблемы семьи. 2014;19(4):40–43.Matsynin A.N., Shaganov P.F., Grebel'naia N.V. Structure of causes of pelvic adhesions in gynecologic pathology in women of reproductive age. Medical and social problems of the family. 2014;19(4):40–43 (in Russ.). 6. Diamond M.P. Reduction of de novo postsurgical adhesions by intraoperative precoating with Sepracoat (HAL-C) solution: a prospective, randomized, blinded, placebo-controlled multicenter study. The Sepracoat Adhesion Study Group. Fertil Steril. 1998;69(6):1067–1074. DOI: 10.1016/s0015-0282(98)00057-0. 7. Braun K.M., Diamond M.P. The biology of adhesion formation in the peritoneal cavity. Semin Pediatr Surg. 2014;23(6):336–343. DOI: 10.1053/j.sempedsurg.2014.06.004. 8. Пучкина Г.А., Сулима А.Н. Современные аспекты патогенеза и профилактики спаечного процесса органов малого таза. Акушерство, гинекология и репродукция. 2020;14(4):523–533. DOI: 10.17749/2313-7347/ob.gyn.rep.2020.107.Puchkina G.A., Sulima A.N. Сurrent aspects of pathogenesis and prophylaxis of pelvic adhesions. Obstetrics, Gynecology and Reproduction. 2020;14(4):523–533 (in Russ.). DOI: 10.17749/2313-7347/ob.gyn.rep.2020.107. 9. Molinas C.R. Peritoneal mesothelial hypoxia during pneumoperitoneum is a cofactor in adhesion formation in a laparoscopic mouse model. Fertil Steril. 2001;76(3):560–567. DOI: 10.1016/s0015-0282(01)01964-1. 10. Захаров И.С., Ушакова Г.А., Демьянова Т.Н. и др. Спаечная болезнь органов малого таза: современные возможности профилактики. Consilium Medicum. 2016;18(6):71–73.Zakharov I.S., Ushakova G.A., Demyanova T.N. et al. Adhesive disease of the pelvic organs: modern prevention opportunities. Consilium Medicum. 2016;18(6):71–73 (in Russ.). 11. Бурлев В.А., Дубинская Е.Д., Ильясова Н.А. и др. Ангиогенез и пролиферация в спайках брюшины малого таза у больных с перитонеальной формой эндометриоза. Проблемы репродукции. 2011;4:10–18.Burlev V.A., Dubinskaia E.D., Il'iasova N.A. et al. Angiogenesis and proliferation in adhesions of the pelvic peritoneum in patients with peritoneal endometriosis. Russian Journal of Human Reproduction. 2011;4:10–18 (in Russ.). 12. Hellebrekers B.W., Kooistra T. Pathogenesis of postoperative adhesion formation. Br J Surg. 2011;98(11):1503–1516. DOI: 10.1002/bjs.7657. 13. Hassanabad A.F., Zarzycki A.N., Jeon K. et al. Post-Operative Adhesions: A Comprehensive Review of Mechanism. Biomedicines. 2021;9:867. DOI: 10.3390.biomedicines9080867. 14. Diamond M.P., Saed G.M. Molecular characterization of postoperative adhesions: the adhesion phenotype. J Am Assoc Gynecol Laparosc. 2004;11(3):307–314. DOI: 10.1016/s1074-3804(05)60041-2. 15. Saed G.M., Diamond M.P. Modulation of the expression of tissue plasminogen activator and its inhibitor by hypoxia in human peritoneal and adhesion fibroblasts. Fertil Steril. 2003;79(1):164–168. DOI: 10.1016/s0015-0282(02)04557-0. 16. Гаспаров А.С., Дубинская Е.Д. Тазовые перитонеальные спайки: этиология, патогенез, диа­гностика, профилактика. М.: Медицинское информационное агентство; 2013.Gasparov A.S., Dubinskaya E.D. Pelvic peritoneal adhesions: etiology, pathogenesis, diagnosis, prevention. M.: Medical Information Agency; 2013 (in Russ.). 17. Thakur M., Rambhatla A., Qadri F. et al. Is There a Genetic Predisposition to Postoperative Adhesion Development? Reprod Sci. 2021;28(8):2076–2086. DOI: 10.1007/s43032-020-00356-7. 18. Ткаченко Л.В., Михин И.В., Минаева Е.А. Профилактика и лечение спаечной болезни малого таза при трубно-перитонеальном бесплодии. Вестник ВолгГМУ. 2010;1(33):63–66.Tkachenko L.V., Mikhin I.V., Minaeva E.A. Prevention and treatment of adhesive disease of small pelvis in tuboperitoneal infertility. Journal of volgograd state medical university. 2010;1(33):63–66 (in Russ.). 19. Awonuga A.O., Chatzicharalampous C., Thakur M. et al. Genetic and Epidemiological Similarities, and Differences Between Postoperative Intraperitoneal Adhesion Development and Other Benign Fibro-proliferative Disorders. Reprod Sci. 2022;29(11):3055–3077. DOI: 10.1007/s43032-021-00726-9. 20. Lee W.L., Liu C.H., Cheng M. et al. Focus on the Primary Prevention of Intrauterine Adhesions: Current Concept and Vision. Int J Mol Sci. 2021;13:22(10):5175. DOI: 10.3390/ijms22105175. 21. Сулима А.Н., Пучкина Г.А. Оценка эффективности комплексного подхода к профилактике послеоперационного спаечного процесса. РМЖ. Мать и дитя. 2021;4(2):130–136. DOI: 10.32364/2618-8430-2021-4-2-130-136.Sulima A.N., Puchkina G.A. Efficacy of complex preventive approach to postoperative pelvic adhesions. Russian Journal of Woman and Child Health. 2021;4(2):130–136 (in Russ.). DOI: 10.32364/2618-8430-2021-4-2-130-136. 22. Ahmad G., Cheong Y.C., Metwally M.E., Watson A.J. The use of adhesion prevention agents in obstetrics and gynaecology. The Use of Adhesion Prevention Agents in Obstetrics and Gynaecology (Scientific Impact Paper, 39). London: Royal College of Obstetricians and Gynaecologists; 2013. 23. Доброхотова Ю.Э., Гришин И.И., Гришин А.И. Опыт применения противоспаечного барьера у пациенток с трубно-перитонеальным фактором бесплодия. РМЖ. 2017;15:1141–1143.Dobrokotova Yu.E., Grishin I.I., Grishin A.I. Experience of the use of an adhesion barrier in patients with tubal peritoneal factor infertility. RMJ. 2017;15:1141–1143 (in Russ.). 24. Torres-De L.A., Campo R., Devassy R. et al. Adhesions and Anti-Adhesion Systems Highlights. Facts Views Vis Obgyn. 2019;11(2):137–149. PMID: 31824635. 25. Schindler A.E. Gonadotropin-releasing hormone agonists for prevention of postoperative adhesions: an overview. Gynec Endocrinol. 2004;19(1):51–55. DOI: 10.1080/09513590410001725495. 26. Hindocha A., Beere L., Dias S. et al. Adhesion prevention agents for gynaecological surgery: an overview of Cochrane reviews. Cochrane Database Syst Rev. 2015;6(1):CD011254. DOI: 10.1002/14651858.CD011254.pub2. 27. Аужанов Д.Б., Аймагамбетов М.Ж., Жагипарова Ж.А. и др. Влияние азатиоприна на формирование спаечного процесса брюшной полости в эксперименте. Новости хирургии. 2019;27(4):369–375. DOI: 10.18484/2305-0047.2019.4.369.Auzhanov D.B., Aymagambetov M.Zh., Zhagiparova Zh.A. et al. Effect of Azathioprine on the Formation of Adhesive Process of the Abdominal Cavity in Experiment. Novosti Khirurgii. 2019;27(4):369–375 (in Russ.). DOI: 10.18484/2305-0047.2019.4.369. 28. Силуянов С.В, Алиев С.Р. Первый опыт применения противо-спаечной коллагеновой мембраны при операциях на органах брюшной полости и малого таза. РМЖ. 2015;13:789.Siluianov S.V., Aliev S.R. The first experience of using anti-spaecal collagen membrane during operations on abdominal and pelvic organs. RMJ. 2015;13:789 (in Russ.). 29. Серикпаев Ж.Ж., Алмабаева А.Ы., Алмабаев Ы.А. и др. Влияние пневмоперитонеума на формирование спаечного процесса при лапароскопических операциях в эксперименте. Проблемы современной науки и образования. 2016;32(74):101–104.Serikpayev Zh., Almabayeva A., Almabayev Y. The impact pneumoperitoneum on the formation of adhesions with laparoscopic surgery in the experiment. Problemy sovremennoj nauki i obrazovaniya. 2016; 32(74):101–104 (in Russ.).

License Creative Commons
This work is licensed under a Creative Commons «Attribution» 4.0 License.
Read the article in PDF in Russian


Previous article
Next article
Secondary messengers of insulin in polyc...
0
2624
Comparative analysis of the monitoring o...
0
1796
All articles

Распечатать