Abstract:
The paper describes a new classification of the adhesive process in the abdominal cavity,
depending on the severity of the adhesive process and the possibility of influencing them
surgically. According to this classification, 5 degrees are distinguished. At grade 1, single
viscero-visceral or viscero-parietal planar adhesions were detected, easily dissected in a blunt
way. At grade 2 - viscero-visceral and viscero-parietal adhesions, the dissection of which must
be performed in an acute way, while the integrity of the intestinal walls is maintained. At grade
3, there were viscero-parietal adhesions, the dissection of which requires excision of the walls of
the abdominal wall in order to preserve the integrity of the intestinal walls, or viscero-visceral
adhesions, the dissection of which contributes to single areas of deserosis of the intestinal walls.
At grade 4, there were viscero-visceral or viscero-parietal adhesions with intimate adhesions
between intestinal loops; attempts to dissect them in an acute way lead to severe violations of the
integrity of the intestinal walls. At grade 5, detected an adhesive conglomerate of the abdominal
cavity, while the isolation of intestinal loops is not possible.
The results of treatment of 148 patients were analyzed. The frequency of postoperative
complications was 20.3%, and the mortality rate was 6.1%. The analysis performed showed the
dependence of the frequency of postoperative complications and mortality on the severity of the
adhesive process.
