- Prevention of postoperative adhesion formation
Prevention of postoperative adhesion formation
HEALTH OF WOMAN. 2015.8(104):55–59; doi 10.15574/HW.2015.104.55
Prevention of postoperative adhesion formation
Zaporozhan V., Volyanska A., Marichereda V., Gladchuk I., Rozhkovska N.
Odessa national medical University
The aim of this study was to assess the prevention of postoperative adhesion formation after using various types of energy at endosurgical treatment based carrier polymorphic alleles of genes ММР1-1607insG, VEGFA/C634G та COL2A1/6846C>A
650 patients with advanced pelvic adhesions after operations on abdominal or pelvic organs were selected for study. All patients were divided into two groups according to type of energy was used during operation: conventional electrosurgical instruments were used in 335 patients (group 1), ultrasonic scalpel was used in 315 cases (group 2). Both groups were further divided into two subgroups according to antibiotic used after surgery. Patients in subgroups ІА (n=170) and ІІА (n=160), received doxycycline 100 mg BDS for 10 days. Subgroupes ІB (n=165) та ІІB (n=155) only received cephalosporin during operation.
DNA was isolated from buccal cells by Dellaport method. Molecular genetic analysis was carried to study MMR1–1607insG, VEGFA/C634G and COL2A1/6846C>A gene polymorphisms in patients enrolled into trial.
Treatment results were evaluated by reproductive function restoration and results of repeated operations.
Detection of heterozygous polymorphism 1607 insG of gene MMR1 in infertile patients indicates a high probability of adhesion formation, the relative risk of the presence of adhesions.
Patients with risk of postoperative adhesion formation adhesions treatment should include precise endosurgical technique with an ultrasonic scalpel and admission of doxycycline (100 mg twice daily for 10 days) after operation.
If patients with infertility with adhesive process have pathological alleles of genes MMP1/-1607 insG, COL2A1/6846C>A, VEGFA/C634 should be encouraged to use assisted reproductive technologies, even in the absence of tubal occlusion, without passing the recovery phase of the reproductive function in the natural cycle.
Key words: adhesions, infertility, endosurgical treatment, MMР1, VEGF, COL2A1.
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