[Infusion pre-hydration and a humid room in the prevention of postoperative adhesions].

E Imparato, F Biffignandi, G Aspesi, E Rovetta, G Piccaluga, C Scarabelli, R Durola, M Russo, M Galbusera, E Pozzi
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Abstract

The Authors after an overview on the most important causes of postsurgical adhesions, drove their attention to the tissue injury determined, during abdominal surgery, by exposure of pelvic serosa to the humidity of operating area. The AA tested body temperature in the Douglas pouch and under the liver on 30 patients who were operated by conservative surgery (myomectomy) and on 8 patient who underwent laparoscopy. A decrease of one degree in the Douglas pouch after one hour on the patient who had a Pfannestiel incision has been detected. While on the patients with longitudinal laparotomy no difference was evidenced. Serosal biopsies done at the beginning of surgery after pelvis exposure to the external conditions (temperature, humidity) showed a marked phlogosis in the tissue of the patients not treated at all. These tissue injuries were almost absent in the group treated with saline tissue irrigation and absent in the group that had parenteral prehydration, too. The AA suggested the use of the two techniques in conservative surgery in order to obtain in the open abdomen surgery results similar to those of the endoscopic one.

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【输注预补水及湿润室预防术后粘连】。
作者在概述了术后粘连的最重要原因后,将他们的注意力转移到腹部手术中由骨盆浆膜暴露于手术区域湿度所确定的组织损伤上。AA检测了30例保守手术(子宫肌瘤切除术)患者和8例腹腔镜手术患者的道格拉斯袋和肝下体温。患者经Pfannestiel切口一小时后道格拉斯眼袋下降一度。而纵向剖腹手术的患者无差异。在骨盆暴露于外部条件(温度、湿度)后,手术开始时进行的浆膜活检显示,未接受治疗的患者组织中有明显的炎症。盐水组织冲洗组和肠外预水化组几乎没有这些组织损伤。AA建议在保守手术中使用这两种技术,以便在开腹手术中获得与内镜手术相似的结果。
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