Complications of intraperitoneal dextran application for prevention of adhesions.

J F Gauwerky, D Heinrich, F Kubli
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Abstract

In 47 patients (dextran group: 32 patients, control group: 15 patients) undergoing laparotomy for microsurgical detachment of adhesions and tuboplasty, the complications of a repeated postoperative intraperitoneal instillation of 6% dextran 60 (5 days) were monitored. In the dextran treated group, abdominal pain and dyspnea occurred significantly more frequently than in the control group. In 6 cases, we observed an edema of the vulva and in two cases an edema of the thigh. During the intraperitoneal irrigation with dextran, a significant increase of body weight and central venous pressure occurred. Bradycardia was observed between the 3rd and 6th postoperative days. Blood pressure remained unchanged. 75% of the patients in the dextran group had pleural effusions containing dextran on the 5th postoperative day. We think that the uncertain desired effects of dextran in the prevention of adhesions do not outweigh the certain and substantial undesired side effects.

葡聚糖腹腔内应用预防粘连的并发症。
对47例(葡聚糖组32例,对照组15例)行剖腹显微手术脱离粘连输卵管成形术的患者,观察术后反复腹腔注射6%葡聚糖60 (5 d)的并发症。右旋糖酐治疗组腹痛和呼吸困难发生率明显高于对照组。其中6例为外阴水肿,2例为大腿水肿。右旋糖酐腹腔灌洗期间,大鼠体重和中心静脉压明显升高。术后第3 ~ 6天出现心动过缓。血压保持不变。葡聚糖组75%的患者术后第5天出现葡聚糖胸腔积液。我们认为葡聚糖在预防粘连方面的不确定的预期效果并没有超过确定的和实质性的不希望的副作用。
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