Kamil Torres1, Łukasz Pietrzyk2, Zbigniew Plewa3, Karolina Załuska-Patel4, Mariusz Majewski4, Elżbieta Radzikowska5, Anna Torres6. 1. Department of Didactics and Medical Simulation, Chair of Human Anatomy, Medical University of Lublin, Lublin, Poland. Electronic address: kamiltorres@wp.pl. 2. Department of Didactics and Medical Simulation, Chair of Human Anatomy, Medical University of Lublin, Lublin, Poland; Department of General, Oncological and Minimally Invasive Surgery, 1st Military Clinical Hospital, Lublin, Poland. 3. Department of General, Oncological and Minimally Invasive Surgery, 1st Military Clinical Hospital, Lublin, Poland. 4. Department of Didactics and Medical Simulation, Chair of Human Anatomy, Medical University of Lublin, Lublin, Poland. 5. Department of Plastic Surgery, Central Clinical Hospital of Ministry of Interior, Warsaw, Poland. 6. Chair and Department of Human Anatomy, Laboratory of Biostructure, Medical University of Lublin, Lublin, Poland.
Abstract
PURPOSE: Intraperitoneal adhesions (IA) develop as a consequence of the healing process in peritoneum injured during surgeries. IA might be formed after all types of surgical interventions regardless the surgical approach with a higher incidence in obese individuals. Here we determine the diagnostic power of TGF-β and blood inflammatory parameters in the prediction of IA in obese patients undergoing second surgical intervention. MATERIALS AND METHODS: Eighty patients were divided into groups according to body mass index (BMI) values and presence of intraperitoneal adhesions (IA). Evaluation of peritoneal adhesion index (PAI), serum TGF-β and blood inflammatory parameters was performed. RESULTS: Level of TGF-β, C-reactive protein (CRP), leukocytes, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio were significantly higher in obese patients while TGF-β, CRP, and leukocytes were higher in patients with IA. There was a significant correlation between PAI values and TGF-β concentration (p<0.001; r=0.869) in IA group. CONCLUSIONS: The preoperative TGF-β concentration, BMI, CRP and NLR could be strong predictors of intraperitoneal adhesions in patients with the history of surgeries.
PURPOSE: Intraperitoneal adhesions (IA) develop as a consequence of the healing process in peritoneum injured during surgeries. IA might be formed after all types of surgical interventions regardless the surgical approach with a higher incidence in obese individuals. Here we determine the diagnostic power of TGF-β and blood inflammatory parameters in the prediction of IA in obesepatients undergoing second surgical intervention. MATERIALS AND METHODS: Eighty patients were divided into groups according to body mass index (BMI) values and presence of intraperitoneal adhesions (IA). Evaluation of peritoneal adhesion index (PAI), serum TGF-β and blood inflammatory parameters was performed. RESULTS: Level of TGF-β, C-reactive protein (CRP), leukocytes, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio were significantly higher in obesepatients while TGF-β, CRP, and leukocytes were higher in patients with IA. There was a significant correlation between PAI values and TGF-β concentration (p<0.001; r=0.869) in IA group. CONCLUSIONS: The preoperative TGF-β concentration, BMI, CRP and NLR could be strong predictors of intraperitoneal adhesions in patients with the history of surgeries.