- Turkish Journal of Medical Sciences
- Vol: 50 Issue: 2
- Does applied ultrasound prior to laparoscopy predict the existence of intra-abdominal adhesions?
Does applied ultrasound prior to laparoscopy predict the existence of intra-abdominal adhesions?
Authors : Hilal Uslu Yuvaci, Arif Serhan Cevrioğlu, Yasemin Gündüz, Nermin Akdemir, Alper Karacan, Ünal Erkorkmaz, Abdurrahim Keskin
Pages : 304-311
Doi:10.3906/sag-1910-61
View : 18 | Download : 5
Publication Date : 9999-12-31
Article Type : Makaleler
Abstract :Background/aim: The purpose of this study was to evaluate the efficacy of trans-abdominal ultrasonography USG , a noninvasive diagnostic tool, in predicting the presence of intraabdominal adhesions, especially near the trocar entry area, to provide safe surgical access to the abdomen. Materials and methods: Fifty-nine women with a previous history of open abdominal surgery group A and a group of 91 women with no previous history of surgery group B underwent dynamic ultrasound evaluation of the abdominal fields before laparoscopic operations. The anterior abdominal wall was divided into six quadrants: right upper, right lower, left upper, left lower, suprapubic, and umbilical. Adhesions were evaluated by surgeons during the operation and by radiologists using USG prior to the operation. Visceral organ movements greater than 1 cm was defined as normal visceral slide positive test , with less than 1 cm of movement defined as abnormal visceral slide negative test . Sliding test measures movements of omental echogenicity or a stable echogenic focus that corresponds to intestine peritoneal echogenicity that underlies abdominal wall during exaggerated inspiration and expiration. Adhesions observed during surgery were evaluated on a four-point scale, with 0 indicating no adhesions present, 1 indicating the presence of a thin, filmy avascular adhesion, 2 indicating the presence of a dense and vascular adhesion, and 3 indicating adhesions that connect surrounding organs with the overlying peritoneal surfaces. The McNemar test was used to compare the results of USG and laparoscopy for each measure. Results: We found that preoperative USG was successful in identifying adhesions [sensitivity, 96.39% 95% CI 89.8-99.2 ; specificity, 97.43%] Conclusion: Preoperative ultrasound examination of the abdominal wall may enhance the safety of abdominal entry during laparoscopic operations.Keywords : Adhesion, laparoscopy, ultrasonography, visceral sliding sign