State-of-the-Art Prevention of Adhesions in Gynecology / UNI-MED Science (PDF)
(Sprache: Englisch)
Intra-abdominal adhesions are a major source for patient morbidity including infertility, chronic pelvic pain and small bowl obstruction. Especially in gynecology, infectious diseases represent the primary cause for adhesions and, in consequence,...
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Intra-abdominal adhesions are a major source for patient morbidity including infertility, chronic pelvic pain and small bowl obstruction. Especially in gynecology, infectious diseases represent the primary cause for adhesions and, in consequence, infertility.
This comprehensive book covers the whole field of adhesions and adhesion related disorders. It will contribute to surgeons becoming more conscious of the adhesions problematic and will give answers on how to treat and how to avoid adhesions. The authors are key opinion leaders in the field of adhesion research and elucidate the problem of adhesions including their pathogenesis, diagnosis and therapy as well as their prognosis.
This book provides up-to-date information and is recommended to all operating gynecologists, but also to colleagues of other disciplines such as surgery or urology.
This comprehensive book covers the whole field of adhesions and adhesion related disorders. It will contribute to surgeons becoming more conscious of the adhesions problematic and will give answers on how to treat and how to avoid adhesions. The authors are key opinion leaders in the field of adhesion research and elucidate the problem of adhesions including their pathogenesis, diagnosis and therapy as well as their prognosis.
This book provides up-to-date information and is recommended to all operating gynecologists, but also to colleagues of other disciplines such as surgery or urology.
Inhaltsverzeichnis zu „State-of-the-Art Prevention of Adhesions in Gynecology / UNI-MED Science (PDF)“
1. The Pathogenesis of Adhesion Formation 12 1.1. Adhesion formation results from abnormal regulation of peritoneal wound healing 12 1.2. The balance between the formation of a fibrin matrix and fibrinolysis 13 1.3. The deposition of extracellular matrix material 13 1.4. Remesothelization, vascularization and innervation of adhesion tissue 13 1.5. The role of cytokines during the process of adhesion formation 14 1.6. Conclusion 15 1.7. References 15 2. State-of-the-Art in Adhesion Prevention 20 2.1. Steps to reduce adhesions 20 2.2. Adhesion-reduction agents 21 2.2.1. Pharmacological agents 22 2.2.2. Physical separators 22 2.2.3. Site-specific mechanical barriers 22 2.2.4. Gel barriers 25 2.2.5. Broad-coverage fluid agents 27 2.2.6. Areas of future research 28 2.3. Cost-effectiveness of anti-adhesion agents 29 2.4. Advising patients of adhesions risk and medicolegal considerations 29 2.5. References 31 3. Postoperative Adhesions and their Prevention 38 3.1. Pathophysiology of adhesion formation 39 3.1.1. The mesothelial cell and the peritoneal cavity 39 3.1.2. The classic model of adhesion formation: a local phenomenon 40 3.1.3. The updated model: The peritoneal cavity as a cofactor 41 3.1.4. Conclusions 41 3.2. Prevalence and clinical consequences of postoperative adhesion formation 42 3.3. Prevention of postoperative adhesion formation 43 3.3.1. Good surgical practice and conditioning of the peritoneal cavity 43 3.3.2. Adhesion prevention in animal models 44 3.3.3. Adhesion prevention in humans 45 3.4. Discussion and outlook 46 3.5. Summary 47 3.6. References 48 4. The Importance and the Timing of Second-Look Laparoscopy 54 4.1. Pathophysiology 54 4.2. Prevention of adhesions 56 4.2.1. Limitation or prevention of initial peritoneal injury 56 4.2.2. Prevention of coagulation of serous exudates 57 4.2.3. Removal or dissolution of deposited fibrin 57 4.2.4. Prevention of adhesions between surfaces of adjacent structures by keeping them apart 57 4.2.4.1. The
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barrier technique 57 4.2.5. Prevention of the organisation of the persisting fibrin by means of inhibition of the fibroblast proliferation 58 4.2.6. Other causes of trauma to the peritoneum 58 4.3. Conclusions 59 4.4. References 59 5. Postoperative Adhesion after Laparoscopic Uterine Reconstructive Surgery 62 5.1. A brief historical note 62 5.2. Uterine reconstructive surgery 63 5.3. Myomectomy 63 5.4. Uterine adenomyosis 64 5.5. Uterine wall abnormalities 66 5.6. Congenital uterine malformations 67 5.7. Uterine adhesiolysis 67 5.8. Discussion 69 5.9. Conclusions 74 5.10. References 75 6. Adhesion Prevention in Severe Endometriosis 80 6.1. Problems caused by adhesions 80 6.2. Methods for adhesion prevention 81 6.2.1. Gore-Tex 81 6.2.2. Interceed 81 6.2.3. Seprafilm 81 6.2.4. SprayGel/SprayShield 82 6.2.5. Adept 82 6.2.6. Intercoat 82 6.2.7. Ovariopexy 82 6.2.8. Second-look laparoscopy 82 6.3. Adhesion prophylaxis in bowel surgery 83 6.4. Personal use of adhesion prevention in patients with endometriosis 83 6.5. Conclusion 83 6.6. References 84 7. The Ultimate Challenge - Definition and Standardized Classification of Adhesions 88 7.1. Classification systems 88 7.2. Literature 90 8. ESGE Consensus on the Management of Adhesions 94 8.1. Actions to reduce adhesions 94 8.2. Summary 94 Index 95
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Bibliographische Angaben
- Autoren: Rudy Leon de Wilde , Ernst Heinrich Schmidt
- 2010, 1. Auflage, 97 Seiten, Englisch
- Verlag: Uni-Med Verlag Ag
- ISBN-10: 383745245X
- ISBN-13: 9783837452457
- Erscheinungsdatum: 19.10.2010
Abhängig von Bildschirmgröße und eingestellter Schriftgröße kann die Seitenzahl auf Ihrem Lesegerät variieren.
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