Pathogenesis of intra-abdominal and pelvic adhesion development

被引:72
作者
Imudia, Anthony N. [1 ]
Kumar, Sanjeev [1 ]
Saed, Ghassan M. [2 ]
Diamond, Michael P. [1 ,2 ]
机构
[1] Wayne State Univ, Div Reprod Endocrinol & Infertil, Dept Obstet & Gynecol, Sch Med,Detroit Med Ctr, Detroit, MI 48201 USA
[2] Wayne State Univ, CS Mott Ctr Human Growth & Dev, Sch Med, Detroit, MI 48201 USA
关键词
postoperative adhesions; intra-abdominal; pelvic; development; pathogenesis; de novo adhesion formation; adhesion re-formation;
D O I
10.1055/s-0028-1082387
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Abdominal and pelvic adhesions are a frequent occurrence and are responsible for significant morbidity resulting in abdominal and pelvic pain, infertility, and small bowel obstruction. The process of adhesion development begins when damage to peritoneal surfaces from any source (operative trauma, infection, foreign bodies, desiccation, irradiation, allergic reaction, or chemical injury) induces a series of biochemical/molecular biologic cascades involving different elements. These elements include peritoneal fluid, neutrophils, leukocytes, macrophages, cytokines, mesothelial cells, and tissue and coagulation factors, which teleologically have the intention of peritoneal repair; however, these processes also result in adhesion development. Major pathways that play significant roles in the healing process of peritoneal damage leading to adhesion development are the fibrinolytic system, extracellular matrix deposition, growth factor and cytokines, cell adhesion molecules, angiogenesis, apoptosis and proliferation, and remesothelialization. Greater understanding of the regulation and interaction of these processes provides the potential for reduction of postoperative adhesion development.
引用
收藏
页码:289 / 297
页数:9
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