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Noninvasive detection and mapping of intraabdominal adhesions: a review of the current literature

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Abstract

Background

Adhesions are a well-known and very common complication to surgery. Their extent and severity varies according to type and number of surgeries, use of intraabdominal mesh, and presence of peritonitis. Adhesions cause increased morbidity and mortality, with subsequent socioeconomic consequences. This review aimed to identify existing literature on noninvasive radiologic techniques for identification of intraabdominal adhesions.

Methods

A structured literature search of medical databases was conducted. English literature published until September 2009 and relevant references were included and assessed.

Results

The search identified transabdominal ultrasonography (TAU) and cine magnetic resonance imaging (cine MRI) as relevant tools matching the search criteria. In all, 12 publications concerning TAU and 4 publications concerning cine MRI were identified. All but one of these publications had the methodologic limitation of not being blinded, which influenced the final sensitivity, specificity, and accuracy.

Conclusion

Both TAU and cine MRI seem able to identify intraabdominal adhesions using visceral slide with accuracy of 76% to 92%. Unfortunately, the studies are biased by being nonblinded. Accordingly, a need exists for a systematic well-conducted double-blinded comparative study to validate these radiologic techniques.

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References

  1. Levrant SG, Bieber EJ, Barnes RB (1997) Anterior abdominal wall adhesions after laparotomy or laparoscopy. J Am Assoc Gynecol Laparosc 4:353–356

    Article  CAS  PubMed  Google Scholar 

  2. Ellis H, Moran BJ, Thompson JN, Parker MC, Wilson MS, Menzies D, McGuire A, Lower AM, Hawthorn RJ, O’Brien F, Buchan S, Crowe AM (1999) Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study. Lancet 353:1476–1480

    Article  CAS  PubMed  Google Scholar 

  3. Tingstedt B, Isaksson J, Andersson R (2007) Long-term follow-up and cost analysis following surgery for small bowel obstruction caused by intra-abdominal adhesions. Br J Surg 94:743–748

    Article  CAS  PubMed  Google Scholar 

  4. van GH (2007) Consequences and complications of peritoneal adhesions. Colorectal Dis 9(Suppl 2):25–34

    Google Scholar 

  5. Sasaki M, Kawabe M, Hirai S, Yamada N, Morioka K, Ihaya A, Tanaka K (2005) Preoperative detection of pleural adhesions by chest ultrasonography. Ann Thorac Surg 80:439–442

    Article  PubMed  Google Scholar 

  6. Balique JG, Benchetrit S, Bouillot JL, Flament JB, Gouillat C, Jarsaillon P, Lepere M, Mantion G, Arnaud JP, Magne E, Brunetti F (2005) Intraperitoneal treatment of incisional and umbilical hernias using an innovative composite mesh: four-year results of a prospective multicenter clinical trial. Hernia 9:68–74

    Article  CAS  PubMed  Google Scholar 

  7. Bingener J, Kazantsev GB, Chopra S, Schwesinger WH (2004) Adhesion formation after laparoscopic ventral incisional hernia repair with polypropylene mesh: a study using abdominal ultrasound. JSLS 8:127–131

    PubMed  Google Scholar 

  8. Aube C, Pessaux P, Tuech JJ, du PR, Becker P, Caron C, Arnaud JP (2004) Detection of peritoneal adhesions using ultrasound examination for the evaluation of an innovative intraperitoneal mesh. Surg Endosc 18:131–135

    Article  CAS  PubMed  Google Scholar 

  9. Arnaud JP, Hennekinne-Mucci S, Pessaux P, Tuech JJ, Aube C (2003) Ultrasound detection of visceral adhesion after intraperitoneal ventral hernia treatment: a comparative study of protected versus unprotected meshes. Hernia 7:85–88

    Article  CAS  PubMed  Google Scholar 

  10. Fischer T, Ladurner R, Gangkofer A, Mussack T, Reiser M, Lienemann A (2007) Functional cine MRI of the abdomen for the assessment of implanted synthetic mesh in patients after incisional hernia repair: initial results. Eur Radiol 17:3123–3129

    Article  PubMed  Google Scholar 

  11. van der Wal JB, Jeekel J (2007) Biology of the peritoneum in normal homeostasis and after surgical trauma. Colorectal Dis 9(Suppl 2):9–13

    PubMed  Google Scholar 

  12. Duron JJ (2007) Postoperative intraperitoneal adhesion pathophysiology. Colorectal Dis 9(Suppl 2):14–24

    Article  PubMed  Google Scholar 

  13. Voskerician G, Jin J, Hunter SA, Williams CP, White M, Rosen MJ (2009) Human peritoneal membrane reduces the formation of intra-abdominal adhesions in ventral hernia repair: experimental study in a chronic hernia rat model. J Surg Res 157:108–114

    Article  CAS  PubMed  Google Scholar 

  14. diZerega GS, Campeau JD (2001) Peritoneal repair and postsurgical adhesion formation. Hum Reprod Update 7:547–555

    Article  CAS  PubMed  Google Scholar 

  15. Holmdahl L (1997) The role of fibrinolysis in adhesion formation. Eur J Surg Suppl (577):24–31

  16. Ellis H (1971) The cause and prevention of postoperative intraperitoneal adhesions. Surg Gynecol Obstet 133:497–511

    CAS  PubMed  Google Scholar 

  17. Sigel B, Golub RM, Loiacono LA, Parsons RE, Kodama I, Machi J, Justin J, Sachdeva AK, Zaren HA (1991) Technique of ultrasonic detection and mapping of abdominal wall adhesions. Surg Endosc 5:161–165

    Article  CAS  PubMed  Google Scholar 

  18. Borzellino G, De MG, Ricci F (1998) Detection of abdominal adhesions in laparoscopic surgery: a controlled study of 130 cases. Surg Laparosc Endosc 8:273–276

    Article  CAS  PubMed  Google Scholar 

  19. Caprini JA, Arcelus JA, Swanson J, Coats R, Hoffman K, Brosnan JJ, Blattner S (1995) The ultrasonic localization of abdominal wall adhesions. Surg Endosc 9:283–285

    CAS  PubMed  Google Scholar 

  20. Hsu WC, Chang WC, Huang SC, Torng PL, Chang DY, Sheu BC (2006) Visceral sliding technique is useful for detecting abdominal adhesion and preventing laparoscopic surgical complications. Gynecol Obstet Invest 62:75–78

    Article  PubMed  Google Scholar 

  21. Kodama I, Loiacono LA, Sigel B, Machi J, Golub RM, Parsons RE, Justin J, Zaren HA, Sachdeva AK (1992) Ultrasonic detection of viscera slide as an indicator of abdominal wall adhesions. J Clin Ultrasound 20:375–380

    Article  CAS  PubMed  Google Scholar 

  22. Kolecki RV, Golub RM, Sigel B, Machi J, Kitamura H, Hosokawa T, Justin J, Schwartz J, Zaren HA (1994) Accuracy of viscera slide detection of abdominal wall adhesions by ultrasound. Surg Endosc 8:871–874

    Article  CAS  PubMed  Google Scholar 

  23. Kothari SN, Fundell LJ, Lambert PJ, Mathiason MA (2006) Use of transabdominal ultrasound to identify intraabdominal adhesions prior to laparoscopy: a prospective blinded study. Am J Surg 192:843–847

    Article  PubMed  Google Scholar 

  24. Marin G, Bergamo S, Miola E, Caldironi MW, Dagnini G (1987) Prelaparoscopic echography used to detect abdominal adhesions. Endoscopy 19:147–149

    Article  CAS  PubMed  Google Scholar 

  25. Steitz HO, Meyer G, Schildberg FW (1997) Ultrasonography of adhesions prior to laparoscopic procedures after previous abdominal operations: current aspects of laparoscopic colorectal surgery. Springer, New York, pp 210–216

    Google Scholar 

  26. Tan HL, Shankar KR, de-Ajayi N, Guelfand M, Kiely EM, Drake DP, De BR, McHugh K, Smith AJ, Morris L, Gent R (2003) Reduction in visceral slide is a good sign of underlying postoperative viscero-parietal adhesions in children. J Pediatr Surg 38:714–716

    Article  CAS  PubMed  Google Scholar 

  27. Tu FF, Lamvu GM, Hartmann KE, Steege JF (2005) Preoperative ultrasound to predict infraumbilical adhesions: a study of diagnostic accuracy. Am J Obstet Gynecol 192:74–79

    Article  PubMed  Google Scholar 

  28. Uberoi R, D’Costa H, Brown C, Dubbins P (1995) Visceral slide for intraperitoneal adhesions? A prospective study in 48 patients with surgical correlation. J Clin Ultrasound 23:363–366

    Article  CAS  PubMed  Google Scholar 

  29. Lienemann A, Sprenger D, Steitz HO, Korell M, Reiser M (2000) Detection and mapping of intraabdominal adhesions by using functional cine MR imaging: preliminary results. Radiology 217:421–425

    CAS  PubMed  Google Scholar 

  30. Katayama M, Masui T, Kobayashi S, Ito T, Sakahara H, Nozaki A, Kabasawa H (2001) Evaluation of pelvic adhesions using multiphase and multislice MR imaging with kinematic display. AJR Am J Roentgenol 177:107–110

    CAS  PubMed  Google Scholar 

  31. Buhmann-Kirchhoff S, Lang R, Kirchhoff C, Steitz HO, Jauch KW, Reiser M, Lienemann A (2008) Functional cine MR imaging for the detection and mapping of intraabdominal adhesions: method and surgical correlation. Eur Radiol 18:1215–1223

    Article  PubMed  Google Scholar 

  32. Lang RA, Buhmann S, Hopman A, Steitz HO, Lienemann A, Reiser MF, Jauch KW, Huttl TP (2008) Cine-MRI detection of intraabdominal adhesions: correlation with intraoperative findings in 89 consecutive cases. Surg Endosc 22:2455–2461

    Article  PubMed  Google Scholar 

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Acknowledgements

Disclosures

Nellie B. Zinther, Jens Fedder, and Hans Friis-Andersen have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Surgical Department, Horsens Hospital, Sundvej 30, 8700, Horsens, Denmark

    Nellie Bering Zinther & Hans Friis-Andersen

  2. Scientific Unit, Horsens Hospital, Horsens, Denmark

    Nellie Bering Zinther & Jens Fedder

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  1. Nellie Bering Zinther
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  2. Jens Fedder
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Correspondence to Nellie Bering Zinther.

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Zinther, N.B., Fedder, J. & Friis-Andersen, H. Noninvasive detection and mapping of intraabdominal adhesions: a review of the current literature. Surg Endosc 24, 2681–2686 (2010). https://doi.org/10.1007/s00464-010-1119-6

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  • DOI: https://doi.org/10.1007/s00464-010-1119-6

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