Experience of using anti-adhesive barriers in colorectal resections in connection with deep infiltrative endometriosis

The adhesive process after excision of the foci of endometriosis is the most common cause of chronic pelvic pain. The wide area of tissue dissection and the resection of the parietal peritoneum in many cases dictate the need to use anti-adhesive barriers at the final stage of surgical treatment. However, the use of these drugs in patients who have undergone colorectal resection is a controversial issue due to the difficulty in diagnosing possible postoperative complications. Objective. Assessment of clinical and laboratory indicators in the early postoperative period and quality of life in the long-term period in patients who underwent colorectal resection. Materials and methods. The study included 30 patients who underwent intestinal resection for deep infiltrative endometriosis using an anti-adhesive barrier (main group 1), and 30 patients after a similar operation without the introduction of an anti-adhesive gel intraoperatively (control group 2). In the postoperative period, clinical symptoms, laboratory and instrumental data were evaluated. Results. In the postoperative period, C-reactive protein was the most sensitive marker of inflammation that correlated with clinical data. On days 1, 2, 3, and 14, the content of C-reactive protein and the level of leukocytes in the blood were monitored in all patients who underwent surgery for infiltrative endometriosis. The severity of the pain syndrome had a positive correlation with the volume of the drug administered in group 1 patients. In the postoperative period, there was an increase in the level of C-reactive protein in patients of the main group compared with this indicator in patients of the control group with a peak in C-reactive protein content on day 2 in patients of the 1st group with a gradual decrease and normalization by day 14. In the late postoperative period, there was a decrease in the severity of pain syndrome in patients of the 1st group. Conclusion. Intraoperative use of anti-adhesive barriers is safe and reduces the likelihood of developing and severity of pain syndrome in the postoperative period.