• Title/Summary/Keyword: abdominal adhesion

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Laparoscopy of hepatocellular carcinoma is helpful in minimizing intra-abdominal adhesion during salvage transplantation

  • Rhu, Jinsoo;Kim, Jong Man;Choi, Gyu Seong;Kwon, Choon Hyuck David;Joh, Jae-Won;Soubrane, Olivier
    • Annals of Surgical Treatment and Research
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    • v.95 no.5
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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.

Sodium Carboxymethylcellulose and Hyaluronic Acid on Prevention of Intra-abdominal Adhesion in Rats (Rat에서 Sodium Carboxymethylcellulose와 Hyaluronic acid의 복강 내 유착 예방)

  • 한태성;이주명;윤영민;강태영;신태균;강윤호;김남중;김희석;이경갑
    • Journal of Veterinary Clinics
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    • v.20 no.3
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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.

Prevention of Abdominal Re-adhesions by Sodium Carboxymethylcellulose in Dogs with Abdominal Adhesions (개에서 복강유착시 Sodium Carboxymethylcellulose를 이용한 재유착의 예방)

  • 정종태;이경갑;장광호
    • Journal of Veterinary Clinics
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    • v.14 no.2
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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.

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Electromyographic Diagnosis of Ruminal Adhesion to Abdominal Wall in Korean Native Goats (한국재래산양에 있어서 제 1위의 복벽유착에 대한 근전도학적 진단)

  • Cheong, Jong-tae;Cheong, Chang-kook;Nam, Tchi-chou
    • Korean Journal of Veterinary Research
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    • v.27 no.2
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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.

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Study on Prevention of Adhesion Formation by Use of Sodium Carboxymethylcellulose and Dextran 70 II. Effect of Administration of Sodium Carboxymethylcellulose and Dextran 70 Solutions on Peripheral Blood Pictures in Adhesion-induced Rabbits (Sodium Carboxymethylcellulose 및 Dextran 70을 이용한 유착형성 방지에 관한 연구 II. 유착자극후 Sodium Carboxymethylcellulose 및 Dextran 70의 투여가 토끼의 혈액상에 미치는 영향)

  • Lee Hyo-Jong;Choi Min-Cheol;Kang Tae-Young;Park Choong-Saeng
    • Journal of Veterinary Clinics
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    • v.10 no.2
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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.

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Study on Adhesion Formation by Artificial Injuries in Rats (쥐에서 인공창상에 의한 유착형성에 관한 연구)

  • Kang Tae-Young;Choi Min-Cheol;Lee Hyo-Jong
    • Journal of Veterinary Clinics
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    • v.9 no.2
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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.

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Prevention of Adhesion Formation by Use of Carboxymethylcellulose and Ibuprofen in Rats (쥐에서 Carboxymethylcellulose 및 Ibuprofen을 이용한 유착형성 방지에 관한 연구)

  • Choi Min-Cheol;Lee Hyo-Jong;Kim Gon-Sup
    • Journal of Veterinary Clinics
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    • v.10 no.2
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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,

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Evaluation on Effectiveness for Preventing Post Surgical Adhesion of Sodium Hyaluronate/Sodium Carboxymethyl Cellulose (HA/CMC) Membrane in Rat Cecum/Peritonium Model (쥐 맹장/복벽 찰과상 모델에서 Sodium Hyaluronate/sodium Carboxymethyl Cellulose 멤브레인의 수술 후 유착방지에 대한 유효성 평가)

  • Lee, Young-Moo;Lee, Young-Woo
    • Membrane Journal
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    • v.15 no.3
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    • pp.213-223
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    • 2005
  • We prepared an anti-adhesion membrane made of sodium hyaluronate/sodium carboxymethylcellulose (HA/CMC) and evaluated its effectiveness for adhesion prevention in a rat model. The anti-adhesion membrane was prepared by lyophilizing HA/CMC solution and cross-linking properly with 1-Ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDAC). In a cecum/abdominal wall abrasion model of Sprague-Dawley rat, cecal serosa and abdominal wall were abraded in $1\times2\;(cm^2)$ with a bone burr after peritoneal midline incision and sutured at 3 points around the injured surface. The denuded cecum was covered with HA/CMC membrane (experimental group), or nothing (control group) and apposed to the abdominal wall. Most of the control group represented 3 or more of adhesion grade at POD 7, 14, 21, and 28, whereas $60\~70\%$ of the experimental group was 2 or less of adhesion grade at 14, 21, and 28. It was similar in the adhesion strength. In a general manner, the adhesion grade and strength showed gradual increasing until POD 14, almost same or a little increasing POD 21, but decreasing POD 28. Also the control group was much higher in adhesion grade, strength, and area than the experimental group. It is expected that the anti-adhesion membrane will have a good clinical result in postoperative adhesion prevention.

Synthesis of Hydrogels for Prevention of Surgical Adhesions by Irradiation (방사선을 이용한 유착 방지용 수화겔 합성기술 개발)

  • No, Yeong-Chang
    • Radioisotope journal
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    • v.21 no.4
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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.

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Two Cases of Laparoscopic Adhesiolysis for Chronic Abdominal Pain without Intestinal Obstruction after Total Gastrectomy

  • Choi, Hyun Jung;Yoon, Sang Chul;Kim, Yong Jin
    • Journal of Gastric Cancer
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    • v.12 no.4
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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.