Peritoneal regeneration and pathogenesis of postoperative peritoneal adhesions formation
Journal Title: Хірургія України - Year 2019, Vol 0, Issue 3
Abstract
Despite the long history of the peritoneal regeneration and the peritoneal adhesions formation pathogenesis studies, as well as a large number of clinical and experimental trials, so far, many questions about the pathophysiology of postoperative adhesions remain controversial. Postoperative formation of peritoneal adhesions is considered to be part of a pathological regeneration process that occurs after any peritoneum injury, especially in connection with surgery. Factors that lead to formation of adhesions are different (mechanical, physical, chemical, infectious, implantation). Inflammatory mediators, free radical oxidation processes, and oxidative stress also play an important role in the modulation of adhesions. A key role in the formation of adhesions belongs to pathological decrease in peritoneal fibrinolytic activity in response to inflammation and surgery. Studies on both animal models and humans have shown that two major factors lead to a decrease in fibrinolysis: a decrease in local tPA activity and an increase in PAI‑1 activity locally and systemically. It is the balance between the activity of tPA and PAI‑1 that plays a central role in the pathological adhesion formation, and the imbalance correlates with the severity of the adhesive process. Thus, pathological adhesion is a multifactorial condition, the development of which is due to a combination of various factors, many of which are genetically determined by local and systemic reactions of the body, and features of surgical treatment. To develop effective methods for prevention and treatment of adhesions, a more complete understanding of this process is needed at both the cellular and molecular genetic levels. The key to preventing post‑operative adhesion formation is likely to be the selective suppression of one or more critical factors that are necessary for its formation. There are practically no works in literature to study the features of adhesions pathogenesis in children.
Authors and Affiliations
M. G. Melnichenko, A. A. Kvashnina
Keywords
Related Articles
- EP ID EP670257
- DOI 10.30978/SU2019-3-88
- Views 118
- Downloads 0
Crohn’s disease: modern diagnosic and treatment
A review of modern laboratory and instrumental methods of diagnosis in patients with Crohn’s disease, their rational combined use is given. Conservative and surgical treatment are considered. Particular attention is paid...
Freeze-dried collagen implant for the surgical treatment of trans-sphincteric anal fistula
The aim — to improve the surgical treatment results of transsphincteric anal fistulas with freezedried collagen implant. Materials and methods. 88 patients with transsphincteric fistulas of rectum were operated in th...
Influence of small intestine wall changes after electrically welded anastomoses of different types for the anastomotic tensile strength
The aim — to study the effect on the clinical rupture properties of the electric welded anastomosis, the morphological transformations in the wall of the small intestine after the linear and multipoint methods applicati...
Collagen type I and III study in the gastroesophageal junction in the patients with hiatal hernia
The aim — to study the collagen I and III composition in samples of the phrenoesophageal ligament in patients with and without hiatal hernia. Materials and methods. The composition of collagen type I and type III was st...
Surgically directed chemotherapy: heated intraperitoneal lavage with a dynamic cytologic control in the complex treatment of pancreatic cancer
The aim — to improve the long‑term treatment results of patients with pancreatic adenocarcinoma at different stages by introducing into the complex therapeutic algorithm of intraoperative and postoperative peritoneal lav...