Adhesive disease of the abdominal cavity: etiomorphopathogenesis, clinic, diagnosis, treatment, and prevention at the present stage
- Authors: Sundeev A.S.1, Andreev A.A.1, Laptiyova A.Y.1, Sazonov P.A.1, Grigorieva E.V.1, Ostroushko A.P.1, Kartashov Y.I.1, Puchnina A.V.1
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Affiliations:
- Voronezh State Medical University named after N.N. Burdenko
- Issue: Vol 30, No 4 (2024)
- Pages: 389-398
- Section: Reviews
- Submitted: 13.02.2024
- Accepted: 21.05.2024
- Published: 09.09.2024
- URL: https://medjrf.com/0869-2106/article/view/626883
- DOI: https://doi.org/10.17816/medjrf626883
- ID: 626883
Cite item
Abstract
During surgery of the gastrointestinal tract, peritoneal adhesions are detected in 80–90% of cases, including in open surgical interventions, and abdominal adhesions occur in 70–90% of patients, with laparoscopic — in 24–35% of patients. The number of deaths from adhesive disease ranges from 14 to 52% and reaches 68% in patients aged >60 years with concomitant pathology.
The main etiological factors of adhesions are mechanical, chemical, physical, and infectious effects. The pathogenesis of adhesion formation includes three processes: inhibition of fibrinolytic and extracellular matrix degradation systems; inflammatory reaction with cytokine production, mainly transforming growth factor β1; and tissue hypoxia due to interruption of blood supply to mesothelial cells and submesothelial fibroblasts. Clinically, adhesive disease of the abdominal cavity is characterized by dyspeptic disorders in the early stages and is accompanied by intestinal obstruction in advanced cases. Adhesive disease treatment can be performed using conservative therapy or surgical intervention. To date, prevention is the most preferred method to impede the consequences of the development of adhesive disease.
Despite improvements in surgical techniques and the development of new approaches to treatment and diagnosis, adhesions remain an inevitable consequence of intra-abdominal operations. Understanding the pathogenesis of the formation of the adhesive process and adhesion and possibility of their transformation, especially at the cellular and molecular level, is beneficial for the development of more effective methods of treatment and prevention of adhesive disease of the abdominal cavity.
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About the authors
Artyom S. Sundeev
Voronezh State Medical University named after N.N. Burdenko
Email: sugery@mail.ru
ORCID iD: 0000-0002-3846-2046
SPIN-code: 8118-2870
Russian Federation, Voronezh
Alexander A. Andreev
Voronezh State Medical University named after N.N. Burdenko
Email: sugery@mail.ru
ORCID iD: 0000-0001-8215-7519
SPIN-code: 1394-5147
MD, Dr. Sci. (Medicine), Professor
Russian Federation, VoronezhAnastasia Yu. Laptiyova
Voronezh State Medical University named after N.N. Burdenko
Email: laptievaa@mail.ru
ORCID iD: 0000-0002-3307-1425
SPIN-code: 7626-9016
Russian Federation, Voronezh
Pavel A. Sazonov
Voronezh State Medical University named after N.N. Burdenko
Email: o25x@yandex.ru
ORCID iD: 0009-0004-7737-4358
SPIN-code: 4526-1477
Russian Federation, Voronezh
Ekaterina V. Grigorieva
Voronezh State Medical University named after N.N. Burdenko
Email: katerina.grigorieva.00@list.ru
ORCID iD: 0009-0007-9037-4813
SPIN-code: 1283-7280
Russian Federation, Voronezh
Anton P. Ostroushko
Voronezh State Medical University named after N.N. Burdenko
Email: anton@vrngmu.com
ORCID iD: 0000-0003-3656-5954
SPIN-code: 9811-2385
MD, Cand. Sci. (Medicine), Associate Professor
Russian Federation, VoronezhYaroslav I. Kartashov
Voronezh State Medical University named after N.N. Burdenko
Email: zhecbrr@gmail.com
ORCID iD: 0009-0009-9754-0508
SPIN-code: 7840-4085
Russian Federation, Voronezh
Alexandra V. Puchnina
Voronezh State Medical University named after N.N. Burdenko
Author for correspondence.
Email: sugery@mail.ru
ORCID iD: 0009-0007-3840-7227
SPIN-code: 4099-3878
Russian Federation, Voronezh
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