Clinical and statistical retrospective analysis of the anamnesis of patients with peritoneal pelvic adhesions

Abstract

The objective: to identify risk factors for the formation of peritoneal adhesions in women of reproductive age. Materials and methods. A retrospective analysis of histories of 187 women who were operated by laparoscopic access and diagnosis of peritoneal adhesions was carried out as the main or concomitant. Data on somatic, reproductive and gynecological history, age and social status were assessed. The comparison group consisted of 65 women in which peritoneal adhesions were not detected during surgery. Results. Analysis of the somatic history of women with and without adhesions in the abdominal cavity showed that women with adhesions had 3.2 (14.97% compared with 4.62%; p <0.05) times more often one or another type of allergy, and 3.5 times more often (10.70% and 3.07% respectively) had autoimmune diseases. Surgical interventions in the past were recorded in both groups, although their number was almost 6 times greater in patients with peritoneal adhesions (53.48% compared to 9.23%; p<0.05). In women with adhesions in the abdominal cavity, the percentage of operations on the pelvic organs was 2.5 times higher (85.00% compared to 33.33%; p<0.05), and only in this category of patients abdominal drainage was performed during surgery (22.4%; p<0.05). The study of gynecological morbidity in the examined women showed that patients with abdominal adhesions had 3.6 times more often inflammatory diseases of the pelvic organs (61.50% compared to 16.92%; p<0.05), and every third had more than one episode of this pathology in history (33.68%; p<0.05). In addition, every fifth woman with adhesions in the abdominal cavity had endometriosis (17.11% compared with 3.08%; p<0.05). A significant proportion of patients in the main group had 2 or more abortions in the past. Conclusions. According to the study results, risk factors for the formation of peritoneal adhesions in women of reproductive age include allergic diseases; surgery on the abdominal organs, especially repeated and performed on pelvic organs; drainage of the abdominal cavity after surgery; inflammatory diseases of the pelvic organs and their recurrences; repeated surgical abortions.