- Irandokht Mehri Mahani
 - - Department of Obstet . and Gynecol Faculty of Medicine, Kerman University of Medical Siences, Kerman, Iran
- Sakineh Mohammad Alizadeh
- - Department of Pediatrics Nursing, Nursing & Midwifery Faculty, Kerman University of Medical Siences, Kerman, Iran
Received: 10/1/2003 Accepted: 10/1/2003 - Publisher : Avicenna Research Institute |
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Abstract
Post operative adhesion is the most common cause of small bowel obstruction, infertility and technical problem in later surgical procedure. According to some results on animals or human, non-closure parietal peritoneum have performed less adhesion. Since there are considerable controversies over closure or non-closure parietal peritoneum on amount of adhesion after cesarean section. 300 pregnant women were included in this study. The parietal peritoneum in 148 patients was closed and in 152 patients left opened. In their next cesarean section, which was at least 31- 34 months later, the amount of adhesion and hernia were evaluated and recorded. The results showed that there were no statistically significant difference between the two groups over age, weight, parity and pelvic infection but there was a significant difference between the interval of two successive surgeries and type of surgeries: elective or emergency (p<0.05 ). the adhesion evaluation of abdominal wall, fascia, peritoneum, omentum, bowel and bladder in non-closure and closure peritoneum patients were 38.5%- 98%, 8.1%- 53.3%, 18.9%- 7.4%, 72.4%- 2.7%, 18.4%- 31.1% and 94.1% respectively. the reaults showed a significant difference in the amount of adhesion between two groups (p<0.001). it was much lower in the non-closure group. the comparision of total score of adhesion with age, weight and parity in two groups were not statistically significant. althouh the results of our study showed the open peritoneum is better than closed parietal peritoneum but we can not generalize for all abdominal surgery. therefore more reseach would be necessary.< pan>
Keywords:
Cesarean section, Pariatal, Peritoneal closure, Peritoneal non- closure, Adhesion, Incisional hernia To cite this article:References
- Dizeraga G.S. Contemporary adhesion prevention. Fertil Steril. 1994;61:219-235.
- Monk B.J., Berman N.L., Montz F.J. Adhesion after extensive gynecologic surgery: Clinical significant, etiology and prevention. Am J Obstet Gynecol.1994;170:1396-1403.
- Dizerega G.S., Rodger K.E. The peritoneum. New York, Springer-Verlage,1992;pp:11-23.
- Raftery A.T.Cellular events in peritoneal repair, a review in pelvic surgery adhesion formation and prevention. New York: Sparinger-Verlag,1997;pp:3-10.
- Gutmann J.N., Diamond M.P. Principles of laparoscopic microsurgery and adhesion prevention practical manual of operative laparoscopy and hysteroscopy. New York, Springer-Verlag,1992;pp:55-64.
- Mowafi D.M.E., Diamond M.P. Gynecologic surgery and subsequent bowel.Obstet Res.2003;1-14.
- Macdonald M.N. Adhesion formation and prevention after peritoneal injury and repair in the rabbit. J Reprod Med.1998;33:436-439.
- Milewczyk M. Experimental studies on the development of peritoneal adhesions cases of suturing and non-suturing of the peritoneum in rabbits. Ginekol pol.1989;609:1-6.
- Ling F.W., Stoval T.G., Mayer N.L. and et al. Adhesion formation associated with use a absorbable staples in comparision to other typers of peritoneal injury. Int J Gynecol Obstet.1989; 30:361-6.
- Elkins T.E., Stovall T.G., Waren J.Ling F.W., Meyer N.L. A historical evaluation of peritoneal repair. Implication for adhesion formation. Obstet Gynecol.1987;70:225-8.
- Liebman S.M., Langer J.C., Marshall J., Collins S. Role of mast cells in peritoneal adhesion formation. Am J.1993;105:127-9.
- Szigetvari I., Feinman M., Barad D., and et al. Association of perivious abdominal surgery and significant ashesion in laparacopic sterilization patients. J Reprod Med.1989;34:456-466.
- Tulandi T., Hum H.S., Gelf M.M. Closure of laparatomy incisions with or without peritoneal suturing and second look laparascopy. Am J Obstet Gynecol.1988;158:536-7.
- Gunningham F.G., Gant N.F., Leveno K.J., Gilistrap L.C., H auth J.C., wenstrom K.D. William,s Obstetircs. 21st Edition, 2001;pp:551.
- Campbell M.J., Machin D. Medical statistics a common sense approach. 2nd Edition.1995;pp:156.
- Berek J.S. Novak’s Gynecology. 13th Edition, 2002;pp:45.
- Scott J.R., Gibbs R.S., Karlan B.Y., Haney A.F. Danfurth’s Obstetrics and Gynecology.9th Edition, 2003; pp:43:758.
- Donnez J., Nissolle M. An atlas of operative laparoscopy and hysteroscopy. 2th Edition, 2001; pp:148-9.
- Stenchever M., Droegmueller W., Herberst AL., Mishell D.R. Comperhensive Gynecology. 4th Edition,2001;pp:1198.
- Stricke B., Binco J. and Fox H.E. the gynecologic contribution to intestinal obstraction in females. J Am Coil Surg.1994,178,pp:617-6,20.
- Kadanali S., Erten O., Kuckozkant T. Pelvic and periaortic peritoneal closure or nonclosure at lymphadencetomy in ovrian cancer. Eur J Surg Oncol.1996;22(3):282-85.
- Bivins J.H.A., Callup D.G. Cesarean section closure techniques which work is best. Obstet Gynecol Management. 2000;(4):98.
- Woyton J., Florjanski J., Zimmer M. Nonclosure of the viceral peritoneum during cesarean section. Ginekol Pol.2000;71(10):1245-50.
- Nather A., Zeisler H., Sam C.E. Husslein P., Joura E.A. Non-closure of peritoneum at cesarean section.Wienklinwochenschr.2001;113(11-12): 451-453.
- Tulandi T., Al Janroudi D. Nonclosure of prentoneum: A reappraisal. Am J Obstet Gynecol. 2003;189(2):609-12.