RESUMO
To determine the major factor that contributed to the formation of adhesions in the abdominal cavity in women with a history of surgical interventions, examined 86 women with adhesive disease (main group) in the past have suffered various surgeries. The average age of patients was 35,7±5,6 years. Clinical examination of patients included a collection of complaints, anamnesis of disease and life, physical examination. The degree of adhesion process in the abdominal cavity was evaluated according to the classification of the American Fertility Society (R-AFS, 1985) and the macroscopic scale proposed by N.I. Ayushinova and co-authors. I severity of adhesions was detected in 32 (37.2%) II stage - in 13 (15.1%), grade III - 14 (16.3%) and IV degree in 27 (31.4%) patients. The duration of the adhesive process averaged 6.3±0.6 years. Adhesions lasting 1-3 years met in 43.0% of cases, 4-5 years - in 31.4% of cases and more than 5 years - in 25.6% of cases. The reason for the formation of adhesions served as inflammatory diseases - at 39.5%, gynecological surgeries - in 32.7% of patients, appendectomy - 20.9%, surgery for acute intestinal obstruction - in 5.8% of patients. After laparotomy adhesions of grade III-IV were formed in 62.5% after laparoscopy - in 33.0% of cases, ie, in 1,9 times less (p <0,05). Adhesions in the abdominal cavity occurs in 39.5% of patients after salpingoophoritis and sexually transmitted infections, as well as in 32.7% women undergoing gynecological surgery. In 32.0% of patients with salpingoophoritis and 44.4% of STIs, there is a III-IV degree of adhesion. The frequency of high adhesion after laparotomy is 62.5%, after laparoscopy - 33.3%.