TITLE:
Abdominal and pelvic adhesions: Possible role of leiomyomas and skin scar anomaly in profiling high risk patients
AUTHORS:
Emmanuel Nzau-Ngoma, Jean-Marie Mbuyi-Muamba, Esimo Mboloko, Massamba Lebwaze
KEYWORDS:
Peritoneum; Peritoneal Adhesions; Abdominal Adhesions; Abdominal Surgery; Leiomyomas; Skin Scar; Kinshasa
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.1,
January
6,
2014
ABSTRACT: Background and aims: Adhesions can cause important morbidity
including abdominal and pelvic pain, intestinal obstructions, and infertility. When
adhesions are formed, there is no efficient method, nowadays, to resolve them, thus
the reduction of their prevalence relies on the prevention. Profiling high risk
patients for abdominal and pelvic adhesions (APA) is an important step to this prevention.
The risk factors of adhesions in our institution, the association between APA, leiomyomas
and skin scar anomaly (SSA) were investigated. Methods: A cross-sectional study
was conducted from March 1st to June 30th 2013 including patients who underwent
laparotomy or laparoscopy. Patients’ characteristics, presence of a SSA and leiomyomas,
as related to adhesions, were analyzed. Student’s t, Pearson’s Khi-square, Fisher’s
Exact, Mann-Whitney tests and logistic regression were used. P values cant. Results:
The frequency of adhesions was 41.74%. Patients had a mean age of 32.69 ±
8.94 years. Those with a previous abdominal surgery (PAS), SSA and leiomyomas had
respectively 12 times [OR: 11.98, CI95 (4.63 - 30.97)], 3 times [OR: 2.79, CI95
(1.16 - 6.71) and 2.5 times [(OR: 2.49, CI95 (1.07 - 5.78)] more adhesions. In logistic
regression, a PAS and leiomyomas remained associated significantly to adhesions
with p = 0.000 and p = 0.037 respectively. Conclusion: In peritoneal adhesions,
leiomyomas and SSA are other factors that may allow a cautious selection of high
risk patients who must benefit from particular attention during surgery. Further
well designed studies are necessary to investigate the accurate clinical relation
among those three conditions.