Pathogenetic aspects of post-surgical adhesions prevention (review of literature)

Abstract

Introduction. It has been established that adhesions in the abdominal cavity are a natural protective and adaptive reaction in response to peritoneal damage, but excessive adhesions are not only a pathological process, but also causes intestinal obstruction in children in 62%.Purpose: to study the pathogenetic aspects of prevention of surgical adhesions.Results. A large number of preventive strategies have been proposed, which are aimed at certain adhesion etiopathogenesis zones, such as inflammation and exudation reduction; coagulation cascade inhibition, fibrin matrix and fibrin deposition formation; fibrinolysis process potentiation; fibroblast proliferation inhibition; neoangiogenesis inhibition; free radical oxidation prevention caused by hypoxia; prevention of contact between damaged peritoneal areas.Conclusions. The problem of prevention of excessive intra-abdominal adhesions remains relevant due to imperfection of the existing variety of methods of prevention and treatment of adhesive intestinal obstruction, and one of the main tasks of its solution in children is to find a sparing and, at the same time, effective way to prevent excessive intra-abdominal adhesions at preoperative, intraoperative and postoperative stages.