1.Long-term outcomes of peroral endoscopic myotomy with simultaneous submucosal and muscle dissection (POEM-SSMD) for achalasia with severe interlayer adhesions.
Jiancong FENG ; Ningli CHAI ; Wengang ZHANG ; Longsong LI ; Xiaowei TANG ; Jiale ZOU ; Lu YE ; Enqiang LINGHU
Chinese Medical Journal 2022;135(6):724-726
2.Advances in clinical application of obstruction catheter in prevention and treatment of intestinal obstruction.
Jun Hao FU ; Ning ZHAO ; Bo LIU ; Xue Dong FANG ; Tong CHEN ; Meng ZHANG ; Zhuo LIU
Chinese Journal of Gastrointestinal Surgery 2021;24(10):931-935
Intestinal obstruction is one of the most common diseases in abdominal surgery, and its prevention and treatment is a clinical difficulty. Although surgical operation can solve the symptoms of obstruction, there are many postoperative complications, and it is easy to develop re-obstruction due to postoperative abdominal adhesion. The internal fixation of small intestine with obstruction catheter provides a new idea for the prevention of postoperative adhesive bowel obstruction. The use of transanal ileus catheter provides the possibility of direct intestinal anastomosis after resection of malignant obstruction in the left hemicolon and can reduce the incidence of postoperative complications. However, sufficient attention should be paid to the related complications, and prevention and treatment should be planned. It is important to note that the use of obstruction catheter is only one of the conservative treatments for bowel obstruction, and it is not a complete replacement of surgery. Surgical treatment should still be considered, if the catheter fails to significantly move, if the obstructive symptoms do not significantly improve 5 days after catheterization.
Catheters
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Digestive System Surgical Procedures
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Humans
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Intestinal Obstruction/surgery*
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Intestine, Small
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Tissue Adhesions
3.Advances in anti-adhesive materials in preventing pelvic and abdominal post-operative adhesions.
Acta Academiae Medicinae Sinicae 2012;34(3):303-306
Post-operative adhesions are a common complication of pelvic and abdominal surgeries. Many approaches for preventing post-operative adhesions have been developed. This review summarizes the recent advances in this topic.
Abdomen
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surgery
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Biomedical and Dental Materials
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Humans
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Pelvis
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surgery
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Postoperative Complications
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prevention & control
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Tissue Adhesions
;
etiology
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prevention & control
4.Efficacy of intrauterine balloon stent or oral estrogen on prevention of adhesion after transcervical resection of septum in septate uterus: Study protocol for a randomized controlled multicenter study in China.
Shan DENG ; Zichen ZHAO ; Limin FENG ; Xiaowu HUANG ; Sumin WANG ; Xiang XUE ; Lei YAN ; Baorong MA ; Lijuan HAO ; Xueying LI ; Lihua YANG ; Lan ZHU
Chinese Medical Journal 2023;136(24):3016-3018
5.Correct conglutination deformities of the upper eyelid after double eyelid operation by relieving infraorbicularis oculi fat flap and infilling.
Jia-qi WANG ; Qian WANG ; Zuo-jun ZHAO ; Wei-zhong LIANG ; Zhi-hong ZHANG ; Yu YANG ; Tai-ling WANG ; Xin GUO ; Shou-duo HU ; Qiang LI ; Li YU ; Hao YU
Chinese Journal of Plastic Surgery 2006;22(2):121-122
OBJECTIVEAdhesive or too highly located folds upper eyelid and even blepharoptosis are common complications of double eyelid operation. To correct such deformities.
METHODWe shifted down the double eyelid line, removed adhesion thoroughly, relieved orbital fat and restarted the volume with infraorbicularis oculi fat flap.
RESULTWe had treated 32 case in past two years. The results were satisfying.
CONCLUSIONThe method are acted easy and gained fine result, so behaving to extend application.
Adipose Tissue ; transplantation ; Adult ; Blepharoplasty ; methods ; Eye Abnormalities ; etiology ; surgery ; Eyelids ; abnormalities ; pathology ; Female ; Humans ; Oculomotor Muscles ; surgery ; Postoperative Complications ; surgery ; Tissue Adhesions ; Young Adult
6.Experimental research on the prevention of rabbit postoperative abdominal cavity adhesion with PLGA membrane.
Xiubing PANG ; Yongming PAN ; Fei HUA ; Chaoying SUN ; Liang CHEN ; Fangming CHEN ; Keyan ZHU ; Jianqin XU ; Minli CHEN
Journal of Biomedical Engineering 2015;32(1):146-162
The aim of this paper is to explore the prevention of rabbit postoperative abdominal cavity adhesion with poly (lactic-co-glycotic acid) (PLGA) membrane and the mechanism of this prevention function. Sixty-six Japanese white rabbits were randomly divided into normal control group, model control group and PLGA membrane group. The rabbits were treated with multifactor methods to establish the postoperative abdominal cavity adhesion models except for those in the normal control group. PLGA membrane was used to cover the wounds of rabbits in the PLGA membrane group and nothing covered the wounds of rabbits in the model control group. The hematologic parameters, liver and kidney functions and fibrinogen contents were detected at different time. The rabbit were sacrificed 1, 2, 4, 6, 12 weeks after the operations, respectively. The adhesions were graded blindly, and Masson staining and immunohistochemistry methods were used to observe the proliferation of collagen fiber and the expression of transforming growth factor β1 (TGF-β1) on the cecal tissues, respectively. The grade of abdominal cavity adhesion showed that the PLGA membrane-treated group was significant lower than that in the model control group, and it has no influence on liver and kidney function and hematologic parameters. But the fibrinogen content and the number of white blood cell in the PLGA membrane group were significant lower than those of model control group 1 week and 2 weeks after operation, respectively. The density of collagen fiber and optical density of TGF-β1 in the PLGA membrane group were significant lower than those of model control group. The results demonstrated that PLGA membrane could be effective in preventing the abdominal adhesions in rabbits, and it was mostly involved in the reducing of fibrinogen exudation, and inhibited the proliferation of collagen fiber and over-expression of TGF-β1.
Abdominal Cavity
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surgery
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Animals
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Collagen
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metabolism
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Lactic Acid
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Polyglycolic Acid
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Rabbits
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Tissue Adhesions
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prevention & control
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Transforming Growth Factor beta1
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metabolism
7.Creation of an animal model for post-operative adhesion prevention.
Chang REN ; Lan ZHU ; Ji-chao SUN
Acta Academiae Medicinae Sinicae 2012;34(2):109-115
OBJECTIVETo establish a rabbit double uterine horn model for assessing the time-course of pelvic adhesions and evaluating the effectiveness of different anti-adhesive materials in reducing adhesions.
METHODSA total of 330 Japanese white rabbits underwent laparotomy, followed by uterine horn incision. Animals were euthanized after 3, 7, 14, 28, and 42 days, respectively.
RESULTSThe surgical procedure was smooth. Rabbit double uterine horn model was applied for the evaluation of pelvic adhesions in a three-dimension fashion. Each of the three means-gauze abrasion, needle holder clamping, and direct uterine incision induced postoperative pelvic adhesions, among which direct uterine incision was the best to mimic conditions after gynecological operations. Under normal circumstances, degradation of filmy fibrinous adhesions by locally released proteases of the fibrinolytic system occurred within 3 days of injury. The regeneration of the mesothelium was completed within 7 days. Collagen reached its peak by day 14. Anti-adhesive materials were supposed to be completely absorbed by day 28, and their effectiveness in preventing pelvic adhesions was confirmed at this time point. Whether their effect can be maintained after the absorption of the anti-adhesive materials was investigated in 42 days.
CONCLUSIONSThe animal model was successfully established. It well mimics the postoperative pelvic adhesions after direct uterine horn injury and thus is a suitable model for studying site-specific adhesions. Observations on the 3rd, 7th, 14th, 28th, and 42nd post-operative days provided a full picture of the adhesion formation process.
Animals ; Biocompatible Materials ; Disease Models, Animal ; Female ; Laparotomy ; Postoperative Complications ; prevention & control ; Rabbits ; Tissue Adhesions ; etiology ; prevention & control ; Uterus ; surgery
8.Update on prevention of epidural adhesion after lumbar laminectomy.
China Journal of Orthopaedics and Traumatology 2015;28(11):1064-1068
Postoperative epidural adhesion is one of the most common causes of failed back surgery syndrome (FBSS), which can lead to back and leg pain or neurological deficit. Prevention of epidural adhesion after laminectomy is critical for improving the outcomes of lumbar surgery. The main origins of epidural fibrosis are raw surface of erector muscles and rupture fibers of intervertebral disc. The main current preventive methods for epidural adhesion include the usage of implants, chemicals and low dose radiation. However, most of them are still in experiment period. There are still controversies on the clinic usage of autograft free fat, ADCON-L, and Mitomycin C (MMC). The optimal implants are characteristics of better biocompatibility, degradable absorption and capability of existing for a certain period in body. The optimal medicine should have good effect on anti-desmoplasia, less side effects and long half-life. Besides, the combination of biodegradable medical film and drug and the mixture of two or more medical films are also the research frontlines of epidural adhesion. Further researches are required to explore new materials and drugs with stable and most favorable effect in preventing epidural adhesion.
Biocompatible Materials
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administration & dosage
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Epidural Space
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pathology
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Humans
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Laminectomy
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adverse effects
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Lumbar Vertebrae
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surgery
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Tissue Adhesions
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prevention & control
9.Microlaparoscopic treatment of adhesive intestinal obstruction in children.
Gan YAO ; Yu-zhou LI ; Jian-sheng LIANG ; Qing-tang YANG
Chinese Journal of Gastrointestinal Surgery 2005;8(2):135-136
OBJECTIVETo evaluate the clinical significance of microlaparoscopic treatment for adhesive intestinal obstruction in children.
METHODSAdhesion -lysis operation was performed in 18 patients with adhesive intestinal obstruct ion by microlaparoscope from March 2001 to January 2004. The clinical data were analyzed retrospectively.
RESULTSMicrolaparoscope assisted accretion-lysis operation was successfully performed in all patients. The operative time ranged from 15 min to 45 min (averaged 30 min), the aerofluxus time ranged from 12 hours to 28 hours (averaged 22 hours) after operation. All patients can take general activity at the first day and take in food at the second day after operation respectively. The hospital stay ranged from 3 to 5 days (averaged 4 days) without complications. All patients were followed-up from 3 months to 18 months (average d 6 months). All patients recovered well without occurrence of adhesive intestinal obstruction.
CONCLUSIONSMicro-laparoscope assisted adhesion-lysis operation is a simple,safe,and feasible approach for adhesive intestinal obstruction in children.
Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Intestinal Obstruction ; pathology ; surgery ; Laparoscopy ; Male ; Retrospective Studies ; Tissue Adhesions
10.Collagen membrane alleviates peritendinous adhesion in the rat Achilles tendon injury model.
Huan ZHAO ; Hong-geng GUAN ; Jun GU ; Zong-ping LUO ; Wen ZHANG ; Bing CHEN ; Qiao-li GU ; Hui-lin YANG ; Qin SHI
Chinese Medical Journal 2013;126(4):729-733
BACKGROUNDTendon adhesion is one of the most common causes of disability following tendon surgery. Therefore, prevention of peritendinous adhesion after surgical repair of tendon is a major challenge. The aim of this study was to explore the possible application of a collagen membrane for the prevention or attenuation of peritendinous adhesions.
METHODSSprague-Dawley (SD) rat Achilles tendon was cut and sutured by a modified Kessler's technique with or without the collagen membrane wrapped. Macroscopic, morphological and biomechanical evaluations were applied to examine the recovery of the injured tendon at 4 and 8 weeks after surgery.
RESULTSThe surgery group wrapped by collagen membranes had a better outcome than the group with surgery repair only. In the collagen membrane-treated group, less adhesion appeared, stronger tensile strength was detected, and more tendon fibers and collagen I expression were observed morphologically.
CONCLUSIONWrapping the tendon with a collagen membrane may be an efficient approach for tendon repair and preventing tendon adhesion after its ruptures.
Achilles Tendon ; injuries ; Animals ; Collagen ; Male ; Rats ; Rats, Sprague-Dawley ; Tendon Injuries ; surgery ; Tissue Adhesions ; prevention & control ; Wound Healing