The effect of training and duration of surgery on adhesion formation in the rabbit model

In order to evaluate the effect of training upon postoperative adhesions, standard bipolar and mechanical, nonopposing injuries were performed in the uterine horns and side walls of 52 mature female rabbits using a conventional three-puncture laparoscopy, by an endoscopic surgeon with limited exp...

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Autores principales: Ordoñez, J.L., Domínguez, J., Evrard, V., Koninckx, P.R.
Formato: Artículo acceptedVersion
Lenguaje:Español
Publicado: 1997
Materias:
R Medicina (General)
Acceso en línea:http://pa.bibdigital.ucc.edu.ar/3723/1/A_Ordo%C3%B1ez_Dom%C3%ADnguez_Evrard_Koninckx.pdf
Aporte de:
Producción Académica Universidad Católica de Córdoba (UCCor) de Universidad Católica de Córdoba
id I38-R144-3723
record_format dspace
institution Universidad Católica de Córdoba
institution_str I-38
repository_str R-144
collection Producción Académica Universidad Católica de Córdoba (UCCor)
language Español
orig_language_str_mv spa
topic R Medicina (General)
spellingShingle R Medicina (General)
Ordoñez, J.L.
Domínguez, J.
Evrard, V.
Koninckx, P.R.
The effect of training and duration of surgery on adhesion formation in the rabbit model
topic_facet R Medicina (General)
description In order to evaluate the effect of training upon postoperative adhesions, standard bipolar and mechanical, nonopposing injuries were performed in the uterine horns and side walls of 52 mature female rabbits using a conventional three-puncture laparoscopy, by an endoscopic surgeon with limited experience. An additional injury, either bipolar or mechanical or both, was performed in the retro-uterine space. With experience, the duration of surgery decreased progressively from 12 K 2 to 8 K 1 min in the first and last 10 animals respectively. The amount of perioperative bleeding was not affected by experience. With experience the postoperative adhesions decreased in extent (P J 0.0001), tenacity (P J 0.004), type (P J 0.002) and inflammation (P J 0.003) and for total score (P J 0.0002). These changes were correlated with the briefer duration of surgery but not with the amount of perioperative bleeding. The strong correlations of adhesion scores in the pouch of Douglas, and around both uterine horns confirmed the importance of the inter-animal variability in making adhesions. By logistic regression, the adhesions in the pouch of Douglas were explained simultaneously by the adhesions on the uterine horns (P J 0.0004, thus correcting for interanimal variability) by the amount of bleeding (P J 0.01) and the duration of surgery (P J 0.05). No major differences were found in adhesions following a mechanical or a bipolar injury or following such a lesion in the pouch of Douglas or at the uterine horns. In conclusion, experience, expressed by the duration of surgery and to a lesser extent perioperative bleeding, is a major co-factor in postoperative adhesions, suggesting that duration of surgery should be strictly standardized in endoscopic adhesion studies. The important inter-animal variability can be circumvented by using a standard control lesion, making each animal its own control.
format Artículo
Artículo
acceptedVersion
author Ordoñez, J.L.
Domínguez, J.
Evrard, V.
Koninckx, P.R.
author_facet Ordoñez, J.L.
Domínguez, J.
Evrard, V.
Koninckx, P.R.
author_sort Ordoñez, J.L.
title The effect of training and duration of surgery on adhesion formation in the rabbit model
title_short The effect of training and duration of surgery on adhesion formation in the rabbit model
title_full The effect of training and duration of surgery on adhesion formation in the rabbit model
title_fullStr The effect of training and duration of surgery on adhesion formation in the rabbit model
title_full_unstemmed The effect of training and duration of surgery on adhesion formation in the rabbit model
title_sort effect of training and duration of surgery on adhesion formation in the rabbit model
publishDate 1997
url http://pa.bibdigital.ucc.edu.ar/3723/1/A_Ordo%C3%B1ez_Dom%C3%ADnguez_Evrard_Koninckx.pdf
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