• Annals of Surgical Treatment and Research
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• 제95권5호
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• pp.258-266
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• 2018

Purpose: This study analyzes the impact of laparoscopic liver resection on intra-abdominal adhesion. Methods: Patients who underwent salvage liver transplantation after liver resection for hepatocellular carcinoma from January 2012 to October 2017 at our institution were included. Information about the severity of intra-abdominal adhesions was collected from a prospectively maintained database. Intra-abdominal adhesions were graded after the agreement of 2 surgeons who participated in the salvage liver transplantation based on predetermined criteria. Adhesion severity and demographic, operative, and postoperative data were compared between the laparoscopic group and the open group. Multivariate logistic regression was performed to consider potential factors related to severe adhesion during salvage transplantation. Results: Sixty-two patients who underwent salvage liver transplantation after liver resection were included in this study. Among them, 52 patients underwent open surgery, and 10 patients underwent laparoscopy. Adhesion was significantly more severe in the open group than in the laparoscopy group (P = 0.029). A multivariate logistic regression model including potential factors related to severe adhesion showed that laparoscopy (odds ratio, 0.168; 95% confidence interval, 0.029-0.970; P = 0.048) was the only significant factor. Conclusion: Laparoscopic liver resection for hepatocellular carcinoma can minimize intra-abdominal adhesion during salvage liver transplantation.

• 한국임상수의학회지
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• 제20권3호
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• pp.323-327
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• 2003

This study has been conducted to compare the efficacy of sodium carboxymethylcellulose (SCMC) and hyaluronic acid (HA) on prevention of adhesion after artificial wound was induced in intestine. 1 % SCMC and 0.3% HA solution and saline solution were respectively administered to abdominal cavity. Each of the three groups consists of 11 rats. The abdominal cavity of each rat was coated with 2 ml of the allocated solution just after the abdomen was cut open, and it was coated with each solution of 1 ml before abrasion were caused on the cecum, the ascending colon and the transverse colon. Then, an additional 1 ml solution was injected before the abdomen was closed. On day 14 after the operation, each adhesion formation was evaluated at the score of 0-4. The HA group and SCMC group showed significantly lower adhesion scores than control group in all regions(P< 0.05). The adhesion scores of ascending colon, transverse colon and no abrasion region of the viscera showed little difference between HA group and SCMC group(P< 0.05), but the effect of adhesion reduction showed higher tendency in the HA group than the SCMC. The adhesion score of the cecum was significantly lower in HA group than SCMC group(P< 0.05). In conclusion, the SCMC solution and HA solution were effective on prevention of abdominal adhesion resulting from the celiotomy. Among of them, the HA solution could be more effective on prevention of adhesion than SCMC solution.

• 한국임상수의학회지
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• 제14권2호
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• pp.161-167
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• 1997

This study was carried out to prevent the abdominal re-adhesions in dogs. Two randomized groups of dogs were subjected to scratch the ileal serosa. Routine abdominal closure was performed on two groups. Second laparotomy was performed one month later for the scoring of the abhesion formation. The adhesions were separated physically after the scoring of the adhesions. In control goup saline was instilled into abdomen and in treated group 1% sodium carboxymethylcellulose(SCMC) solution was instilled into abdomen before the abdominal closure. Third laparotomy was performed another month later to evaulate the adhesions. Reduced adhesion formation following the instillation of 1% SCMC was reported. 1% SCMC is recommended to prevent the re-adhesions as well as adhesions.

• 대한수의학회지
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• 제27권2호
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• pp.335-337
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• 1987

This study was made to determine possibility of the electromyographic diagnosis of the experimentally induced adhesion of rumen to abdominal wall in goats. In goats with experimentally induced ruminal adhesion, the electromyograms were recorded at the abdominal wall accompanying with the ruminal motility. There were, however, no electromyographic recordings during ruminal motility in goats without ruminal adhesions. It was concluded that the electromygrams could be available for the diagnosis of the ruminal adhesion to abdomieal wall in ruminants.

• 한국임상수의학회지
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• 제10권2호
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• pp.227-235
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• 1993

The effectiveness of sodium carboxymethylcellulose(SCMC) and dextran 70 in the prevention of adhesion formation in abdominal cavity of rabbits following artificial injuries was elucidated and the effects -of these medicines on blood pictures were also examined. After abrasion treatment on jejunum in gonadotropins primed rabbits, 1, 2 and 3% of SCMC solutions, 6 and 10% dextran 70 solutions and a synthetic solution of 1% SCMC and loft dextran 70 in 0.9% saline solution were infused into the abdominal cavity. Four weeks later the abdominal cavities were reopened under general anesthesia. The synthetic solution showed the highest adhesion reduction rate(100%), while 1% SCMC, 6 and loft dextran solutions showed no significantly evident effect of adhesion prevention. The SCMC solutions showed better adhesion reduction effect than dextran 70 solutions. After infusion of these adhesion preventive medicines, the changes of total leucocytes, erythrocytes, lymphocytes, PCV, plasma fibrinogen and protein contents were examined. No remarkable difference in blood pictures was shown between the synthetic solution and the other medicines. Therefore, it can be suggested that the synthetic solution of 1% SCMC and 10% dextran 70 in 0.9% saline solution at dose of 5$m\ell$/kg of body weight is prominently effective in the prevention of postoperative adhesion formation and wolf be safe in animals and human.

• 한국임상수의학회지
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• 제9권2호
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• pp.483-488
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• 1992

This experiment was carried out to establish the grade of adhesion formation and changes of blood following artificial injuries such as abrasion, incision and electrocautery on colon and uterine horns in rats. 36 rats (abrasion-, incision-, electrocautery-treated groups) had laparotomy and abdominal injuries, twelve rats( control group) had only laparotomy, Ten days fellowing abdominal injuries, the score of adhesion formation and changes of blood were noted 1. Electrocautery-treated group was significant evident in adhesion formation in colon(p<0.01) and electrocautery and incision-treated groups were more evident than abrasion and control group in uterine horns(p<0.01) 2. Changes of erythrocytes number and PCV were tended to decrease during 5 days after operation, but recover normal level 10 days after operation. 3. Changes of leucocytes number were showed to significantly increase in electrocautery and incision-treated groups 5 days after operation. 4. The electrocautery-treated group was showed to significantly decrease in plasma protein and increase in plasma fibrinogen concentration.

• 한국임상수의학회지
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• 제10권2호
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• pp.203-214
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• 1993

With the use of a rat surgical model, the ability of carboxymethylcellulose and ibuprofen in the reduction of abdominal adhesion was examined. Seventy seven female rats were randomly divided into 7 groups : (1) control, (2) 2% CMC, (3) 3% CMC, (4) ibuprofen 25mg, (5) ibuprofen 50mg, (6) combination of ibuprofen 25mg and 2% CMC and(7) combination of ibuprofen 50mg and 3%, CMC. Following induction of abrasion injuries on ileum, colon and both uterine horns with a surgical blads, the rats in groups (2), (6) were infused with 2% CMC solution singly or in combined Infection of 25 mg/kg of ibuprofen for three consecutive days, the rats In groups (3), (7) were infused with 3% CMC solution singly or In combined Injection of 50mg/kg of ibuprofen for three consecutive days. The rats in groups (4), (5) were injected only with 25 mg or 50 mg/kg of ibuprofen for three consecutive days. After 10 days the abdominal cavities were opened and the appearance of formed adhesion were graded. The changes of body weight, CBC and blood chemicals were also evaluated at 3, 6 and 10 days after operation. In ileum, the rats in the groups (2), (6) and (7) showed less adhesion formation. In colon, there were significant differences(p<0.05) in adhesion formation in all treated groups as compared to control. In both uterine horns, there were significant decrease(p<0.05) of adhesion formation in groups(2), (6) and (7) in comparison with other groups. The increasing rate of body weight was evident in group (3) and fibrinogen concentrations at 6 and 10 days revealed significant decrease (p<0.01) in group (7), whereas there was no consistent change in CBC and blood chemicals. Therefore, it can be sugested that the infusion of 2% CMC solution with or without the injection of 25 mg/kg of ibuprofen and 3% CMC solution with the injection of 50 mg/kg of ibuprofen are effective and safe following abdominal surgery,

• 멤브레인
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• 제15권3호
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• pp.213-223
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• 2005

본 연구에서는 히알루론산나트륨/카르복시메틸셀룰로오스나트륨(HA/CMC)으로 구성된 유착방지 막을 제조하였고, 쥐에서 유착방지용에 대한 효과를 평가하였다. 유착방지 막은 HA/CMC 용액을 동결건조한 후 1-에틸-3-(3-디메틸아미노프로필)카보디이미드 (EDAC)로 가교하여 제조하였다. Sprague-Dawley쥐의 맹장/복벽 찰과상 모델에서 복부 중앙선 절개 후 장막과 복벽을 bone burr로 $1\times2\;(cm^2)$ 크기로 찰과상을 만들고, 상처 면 주위의 3곳을 봉합사로 고정시켰다. 상처난 장을 실험군의 경우 HA/CMC 막으로 덮어주었으며, 대조군은 아무처치도 하지 않은 상태로 복벽을 마주보게 하였다. 대조군의 대부분은 수술 후 7, 14, 21, 28일에 유착정도 3 이상을 나타내었고, 반면 실험군의 $60\~70\%$는 수술 후 14, 21, 28일에 유착정도 2 이하를 나타내었다. 이는 유착세기에서도 유사하였다. 일반적으로 유착정도와 유착세기는 수술 후 14일까지 점차 증가하였고, 수술 후 21일에는 거의 동일하거나 약간 증가하였으며, 28일째에는 감소하였다. 대조군은 유착정도와 유착세기, 유착면적에서 높은 수치를 나타내었다. 이 유착방지막은 수술 후 유착방지에서 좋은 임상결과를 나타낼 수 있을 것으로 기대된다.

• 동위원소회보
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• 제21권4호
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• pp.46-54
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• 2006

Biocompatible and biodegradable hydrogels based on carboxymethyl cellulose(CMC) and polyethyleneglycol(PEG) were prepared far physical barriers for preventing surgical adhesions. These interpolymeric hydrogels were synthesized by a gamma irradiation crosslinking technique. The 1Scmxl.Scm of cecal serosa and adjacent abdominal wail were abraded with bane burr until tbe serosal surface was disrupted and hemorrhagic but not perforated. and the serosa of tbe cecum was sutured to the abdominal wall in 5mm apart from the injured sire. The denuded cecum was covered with either CMC/PEG hydrogels or solution from CMC/PEG hydrogel. Control rat serosa was not covered. Two weeks later. the rats were sacrificed and adhesion was scored on a 0-5 scale. No treatment showed the significantly higher incidence of adhesions than either CMC/BEC hydrogels or solution from CMC/PEG hydrogel. In conclusion, these studies demonstrate that CMC/BEG hydrogels have a function of prevention of intra abdominal adhesion in a rat model.

• Journal of Gastric Cancer
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• 제12권4호
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• pp.249-253
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• 2012

Chronic abdominal pain remains a challenge to all known diagnostic and treatment methods with patients undergoing numerous diagnostic work-ups including surgery. However, the surgical treatment of patients with chronic intractable abdominal pain is controversial. There has been no discussion of the indications for adhesiolysis in cases of obstruction or strangulation of the bowel, and adhesiolysis by laparotomy has never gained acceptance as a treatment modality for chronic abdominal pain. One of the reasons for this lack of acceptance is the high complication rate during and after adhesiolysis. Laparoscopic surgery has been accepted as a technique for diagnostic and therapeutic procedures in general surgery. Laparoscopy allows surgeons to see and treat many abdominal changes that could not otherwise be diagnosed. Here we report two cases of successful symptomatic improvement through laparoscopic adhesiolysis for chronic abdominal pain without intestinal obstruction after total gastrectomy.