Detection of peritoneal adhesions using ultrasound examination for the evaluation of an innovative intraperitoneal mesh

被引:30
作者
Aubé, C
Pessaux, P
Tuech, JJ
du Plessis, R
Becker, P
Caron, C
Arnaud, JP [1 ]
机构
[1] Univ Hosp Angers, Internal Surg Serv, F-49033 Angers, France
[2] Univ Hosp Angers, Dept Radiol, F-49033 Angers, France
[3] Sofradim Prod, F-01600 Trevoux, France
来源
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2004年 / 18卷 / 01期
关键词
ultrasound; peritoneal adhesion; hernia; intraperitoneal mesh;
D O I
10.1007/s00464-003-9056-2
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: In this multicenter study, we evaluated the efficiency of a specific ultrasound examination in detecting postoperative bowel adhesions and assessed the adhesion rate associated with the intraperitoneal use of Parietex composite mesh (polyester mesh covered on the visceral side by a hydrophilic resorbable film). Methods: Eighty patients (36 male, 44 female; average age, 58.2 years [ranges 30-80]) were included in a study carried out at eight centers. The main inclusion criterion was the surgical treatment of incisional and umbilical hernias using an intraperitoneal mesh. The results of a preoperative ultrasound examination were compared to a macroscopic perioperative exploration. In addition, in 76 of the 80 patients, a postoperative ultrasound examination was repeated at 2 and 12 months. Results: The ultrasound findings for peritoneal adhesion detection were as follows: sensitivity, 77%; specificity, 74%; positive predictive value, 65%; negative predictive value, 84%; accuracy, 75%. Postoperative adhesions after 1 year were detected in 14% of patients. Conclusions: Although these patients had undergone repeated surgery and treated to be (obese) body mass index (mean, 28), the-ultrasound exam had a high accuracy rate; when it was negative, there were no adhesions in 84% of cases. The use of a hydrophilic composite mesh is associated with a low rate of adhesions (14%).
引用
收藏
页码:131 / 135
页数:5
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