RETROSPECTIVE ANALYSIS OF ANAMNESIS OF WOMEN WITH PERITONEAL COMMISSURES
DOI:
https://doi.org/10.11603/2415-8798.2018.4.9817Keywords:
adhesive disease, anamnesis, surgical interventions, risk factorsAbstract
The problem of peritoneal commissures is of general medical importance; obstetrician-gynecologists and surgeons constantly face it in their practice. Commissures between the abdominal organs mainly occur as a result of surgical interventions and inflammatory processes of the pelvic organs. They lead to such complications as tuboperitoneal infertility, chronic pelvic pain syndrome, dysfunction of visceral organs.
The aim of the study – to identify risk factors for the formation of peritoneal adhesions in reproductive age women.
Materials and Methods. A retrospective analysis of histories and 187 women who were operated by laparoscopic access and diagnosis of adhesive disease was carried out as the main or concomitant. Data on somatic, reproductive and gynecological history, age and social status were assessed. The comparison group consisted of data from 65 women in whom abdominal adhesions during surgery were not detected.
Results and Discussion. Analysis of the somatic history of women with and without adhesions in the abdominal cavity showed that women with adhesions had 3.2 (14.97 compared with 4.62 %, p<0.05) times more often one or another type of allergy, and 3.5 times more (10.70 and 3.07 %) – autoimmune diseases. Surgical interventions in the past were recorded in both groups, although their number was almost 6 times higher in case of adhesive disease presence (53.48 % compared to 9.23 %, p<0.05). In women with adhesions in the abdominal cavity, the percentage of operations on the pelvic organs was 2.5 times higher (85.00 % compared to 33.33 %, p<0.05), and only in this category of patients was performed abdominal drainage during surgery (22.4 %, p<0.05). The study of gynecological morbidity in the examined women showed that patients with abdominal adhesions had 3.6 times more often inflammatory diseases of the pelvic organs (61.50 % compared to 16.92 %, p<0.05), and every third had more than one episode of this pathology in history (33.68 %, p<0.05). In addition, every fifth woman with adhesions in the abdominal cavity had endometriosis (17.11 % compared with 3.08 %, p<0.05). A significant proportion of patients in the main group have had 2 or more abortions in the past.
Conclusions. According to the study results, risk factors for the formation of peritoneal adhesions in reproductive age women include allergic diseases; surgery on the abdominal organs, especially repeated and pelvic organs; drainage of the abdominal cavity after surgery; inflammatory diseases of the pelvic organs, and their recurrences; repeated surgical abortions.
References
Zaliznyak, V.O. (2015). Zapalni zakhvoriuvannia zhinochykh statevykh orhaniv: navchalnyi posibnyk dlia samostiinoi roboty studentiv V-VI kursiv medychnoho fakultetu ta likariv-interniv akusheriv-hinekolohiv [Inflammatory diseases of female genital organs: a manual for independent work of students of the V-VI courses of the medical faculty and obstetricians-gynecologists interns]. Zaporizhzhia: ZDMU, p. 95 [in Ukrainian].
Kondratyuk, V.K., Emets, N.O., Koblosh, N.D., Arhipova, N.A., Grigorovich, L.V., & Cherkova, L.O. (2010). Zlukova khvoroba v hinekolohii: vid patohenezu do profilaktyky (metodychni rekomendatsii) [Adhesive disease in gynecology from pathogenesis to prevention (guidelines)]. Kyiv, p. 4 [in Ukrainian].
Volyanska, A.G. (2016). Patohenetychne obgruntuvannia profilaktyky spaikovoho protsesu pry hinekolohichnykh operatsiiah u zhinok reproduktyvnoho viku (kliniko-ekperymentalne doslidzhennia) [Pathohenetic substantiation of prevention of adhesion process in gynecological operations in women of reproductive age (clinical and experimental study)]. Candidate’s thesis. Kiyiv, p. 21 [in Ukrainian].
Matsyinin, A.N., Shaganov, P.F., & Grebelnaya N.V. (2014). Struktura prichin spaechnogo protsessa organov malogo taza pri ginekologicheskoy patologii u zhenschin reproduktivnogo vozrasta [The structure of the causes of the special process of pelvic organs with gynecologic pathology in women of reproductive age]. Medyko-sotsialni problemy simi – Medico-social problems of the family, 19, (4), 40-43 [in Russian].
Chermak, I.I. (2015). Empirichna protyzapalna terapiia hostroho salpinhooforytu [Empirical anti-inflammatory therapy of acute salpingophoritis]. Aktualni pytannia pediatrii,akusherstva, ta hinekolohii – Current issues in pediatrics, obstetrics, and gynecology, 2, 187-190 [in Ukrainian]. DOI: https://doi.org/10.11603/24116-4944.2015.2.4820
Taran, O.A. (2006). Suchasni pidhodi do likuvannia ta profilaktyky pisliaoperatsiinoho spaikovoho protsesu [Modern approaches to the treatment and prevention of postoperative adhesion process]. Reproduktivnoe zdorove zhenschiny – Reproductive health of women, 4 (29),125-127 [in Ukrainian].
Dubchak, A.E., Luk’yanova, I.S., & Mandziy, I. M (2012). Stan tazovoi hemodinamiky u zhinok z bezplidnistiu, yaka suprovodzhuetsia hronichnym tazovym bolem [State of pelvic hemodynamics in women with infertility, which is accompanied with chronic pelvic pain]. Zdorove zhenschiny – Women's Health, 2, 169-171 [in Ukrainian].
Ventskovskiy, B.M., Stepankivska, G.K., & Yarotskiy, M.E (Eds.) (2011). Ginekolohiia: pidruchnyk [Gynecology: a textbook]. Kyiv: VSV Meditsina, p. 352 [in Ukrainian].
Tarasenko, Yu.N, Salov, I.A., Tashuhozhaeva, D.T., & Marshalov, D.V. (2013). Vnutrimatochnyye sinehii: sovremennyi vzglyad na problemu [Intracrauterine sinechias: modern view on the problem]. Sovremennyye problemy nauki i obrazovaniya – Modern problems of science and education, 4. Retrieved from http://www.science-education.ru/ru/article/view?id=9924 [in Ukrainian].
Medvedev, M.V. (2015). Spaechnyy protsess v ginekologii [Adhesion process in gynecology]. Zdorove zhenschiny – Women's Health, 3 (99), 42-46 [in Russian].
Boychuk, A.V. (1997). Osoblyvosti funktsionalnykh porushen hipofizarno-yayechnykovoi systemy u zhinok z zapalnymy protsesamy prydatkiv matky [Features of functional disorders of the pituitary-ovarian system in women with inflammatory processes of the appendages of the uterus]. PAH – PAG, 6, 95-98 [in Ukrainian].
Adamyan, L.V., Mynbayev, O.A., & Otuo, F.L. (1993). Otsenka effektivnosti primeneniya protivovospalitelnykh sredstv v eksperimente [Evaluation of the effectiveness of the use of anti-inflammatory drugs in the experiment]. Byulleten eksperimentalnoy biologii i meditsiny – Bulletin of experimental biology and medicine, 1, 68-69 [in Russian].
Serov, V.N., & Ilyenko, L.N. (1997). Biologicheskiye effekty endotoksina i kliniko-patogeneticheskiye reaktsii pri vospalitelnykh zabolevaniyakh polovykh organov u zhenshchin [Biological effects of endotoxin and clinical and pathogenetic reactions in inflammatory diseases of the genital organs in women]. Akusherstvo i ginekologiya – Obstetrics and gynecology, 3, 11-13 [in Russian].
Mayborodin, I.V., Velichko, YA.I., & Pleshakov, V.P. (1999). Strukturnaya organizatsiya spayek bryushnoy polosti i stenok kishok pri lechenii peritonita sorbentom s adsorbirovannym metronidazolom ili lipoorizonom (eksperimentalnoye issledovaniye) [Structural organization of adhesions of the abdominal cavity and intestinal walls in the treatment of peritonitis with a sorbent with adsorbed metronidazole or liporisone (experimental study)]. Khirurgiya – Surgery, 2, 24-28 [in Russian].
Bakuridze, E.M., Dubnitskaya, L.V., & Fedorova, T.A. (2001). Reabilitatsiya patsiyentok s besplodiyem posle rekonstruktivno-plasticheskikh operatsiy na organakh malogo taza [Rehabilitation of patients with infertility after reconstructive plastic surgery on the pelvic organs]. Zhurn. akusherstva i zhen. bolezney – Journal of Obstetrics and Women's Diseases, 3, 47-51 [in Russian].
Feskov, A.E., & Gavrikov, A.Ye. (2014). Peritonealnyye spayki: patogenez i profilaktika [Peritoneal adhesions: pathogenesis and prevention]. Novosti meditsiny i farmatsii – News of medicine and pharmacy, 20 (522), 2-3 [in Russian].
Domoratskiy, A.E., Krylyuk, V.O., Pavlenko, A.I., Pyatkovskaya, N.V., & Sozanskiy V.V. (2016). Spayechnaya bolezn: sovremennoye sostoyaniye problemy [Adhesive disease: current state of the problem]. Hostri ta nevidkladni stany v praktytsi likaria – Acute and urgent conditions in the practice of a doctor, 3-4 (60-61), 19-26 [in Russian].
Lavrinenkova, I.Z. (2005). Effektivnost ambulatornoy reabilitatsii reproduktivnogo zdorovya posle khirurgicheskogo lecheniya ginekologicheskikh zabolevaniy [The effectiveness of outpatient rehabilitation of reproductive health after surgical treatment of gynecological diseases]. Candidate’s thesis. Moskva [in Russian].
Yakubovich, D.V., & Milanov, N.O. (1991). Sistema obsledovaniya i etapy vosstanovitelnogo lecheniya zhenshchin posle mikrokhirurgicheskikh rekonstruktivnykh operatsii pri trubno peritonealnom besplodii [Examination system and stages of rehabilitation treatment of women after microsurgical reconstructive surgery for tubo-peritoneal infertility]. Akush. i gin. – Obs. & Gyn., 4, 44-47 [in Russian].
Apresyan, S.V. (2003). Optimizatsiya vosstanovleniya fertilnosti u zhenshchin s trubno peritonealnym besplodiyem [Optimization of fertility recovery in women with tubo-peritoneal infertility]. Candidate’s thesis. Moskva [in Russian].
Dronova, V.L., Lutsenko, Ye.V., Teslik, R.S., & Nastashenko M.I. (2014). Spayechnaya bolezn organov malogo taza i bryushnoy polosti. Literaturnyy obzor nauchnykh rabot [Adhesive disease of the pelvic organs and abdominal cavity. Literary review of scientific works]. Reproduktivnaya yendokrinologiya – Reproductive endocrinology, 3 (17), 22-28 [in Russian].
Melnychenko, H.N., Kvashnina, A.A., Vasylchenko, L.V., & Vesilyk, N.L. (2016). Suchasni uiavlennia pro patohenez perytonealnykh spayok u ditey [Contemporary notions about the pathogenesis of peritoneal adhesions in children]. Klinichna khirurhiia – Clinical Surgery, 12, 72-75 [in Russian].
Kostyrnoy, A.V., Groyzik, K.L., & Mustafayeva S.R. (2013). Spayechnaya bolezn bryushiny: nastoyashcheye i budushche problemy [Adhesive peritoneal disease: present and future of problem]. Tavricheskiy mediko-biologicheskiy vestnik – Tavrichesky Medical-Biological Bulletin,16 (1), 3 (61), 262-267 [in Russian].
Puziy, O.M. (2016). Diahnostyka, khirurhichne likuvannia ta reabilitatsiia reproduktyvnoi funktsii pry dobroiakisnykh zakhvoriuvanniakh henitaliy u zhinok [Diagnostics, surgical treatment and rehabilitation of reproductive function in benign genital diseases in women]. Candidate’s thesis. Kyiv [in Ukrainian].
Orsich, Ye.O., Zhidkov, S.A., & Zhidkov, A.S. (2016). Problema spayechnoy bolezni bryushnoy polosti [The problem of adhesive disease of the abdominal cavity]. Molodoy uchenyy – Young scientist, 7, 418-421 [in Russian].
Ishchenko, A.I., & Kudrina, Ye.A. (2002). Endometrioz: diagnostika i lecheniye [Endometriosis: diagnosis and treatment]. M. : GEOTAR-MED [in Russian].
Totchiyev, G.F. (2013). Spayechnaya bolezn: fiziologicheskiye aspekty, mekhanizmy preduprezhdeniya [Adhesive disease: physiological aspects, prevention mechanisms]. Effektivnaya farmakoterapiya – Effective pharmacotherapy, 28, 18-20 [in Russian].
Kononov, S.N., Shklyar, A.A., Kozachenko, A.V., & Adamyan, L.V. (2015). Formirovaniye spayek pri endometrioze i puti ikh profilaktiki (obzor literatury) [Formation of adhesions in endometriosis and ways to prevent them (literature review)]. Problemy reproduktsii – Problems of reproduction, 21(2), 82-87 [in Russian].
Somigliana, E., Vigano, P., Benaglia, L., Busnelli, A., Vercellini, P., & Fedele, L. (2012). Adhesion Prevention in Endometriosis: A Neglected Critical. Journal of Minimally Invasive Gynecology, 19 (4), 415-421.
Avramenko, N. V. (2014). Vospalitelnyye zabolevaniya organov malogo taza u zhenshchin kak vedushchiy faktor formirovaniya trubno-peritonealnogo besplodiya [Inflammatory diseases of the pelvic organs in women as the leading factor in the formation of tuboperitoneal infertility]. Zaporozhskiy meditsinskiy zhurnal – Zaporozhye Medical Journal, 4 (85), 63-68 [in Russian].
Kachalina, T.S., & Morozova, K.V. (2008). Klinichesko-immunologicheskiye aspekty razlichnykh metodik meditsinskogo aborta [Clinical and immunological aspects of various methods of medical abortion]. Meditsinskiy almanakh – Medical Almanac, 5, 118-121 [in Russian].
Downloads
Published
Issue
Section
License
Authors who sent their manuscript to "Вісник наукових досліджень. Bulletin of Scientific Research" Surgery agree to the following terms:
a. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal. 
b. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
c. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
