OB-GYN-L Messages for March, 2008: =?iso-8859-1?B?UmU6ID0/SVNPLTg4NTktOT9RP1JlOl9ZYW79dDpfcGVyaXRv? neum?In-Reply-To: <6378.55172.qm@web33204.

=?iso-8859-1?B?UmU6ID0/SVNPLTg4NTktOT9RP1JlOl9ZYW79dDpfcGVyaXRv? neum?In-Reply-To: <6378.55172.qm@web33204.

From: FRANCES WREN

fwren@shaw.ca

Thu Mar 6 21:03:39 2008

thanks for this article. I shall continue to non-close the peritoneum frances wren

>----- Original Message -----
From: johnprov@sympatico.ca (Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.) Date: Thursday, March 6, 2008 8:55 pm Subject: Re: =?ISO-8859-9?Q?Re:_Yanýt:_peritoneum?In-Reply-To: <6378.55172.qm@web33204.mail.mud.yahoo.com> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net>

> J Obstet Gynaecol Res. 2006 Aug;32(4):396-402. Links > Prospective study of non-closure or closure of the peritoneum at > cesarean delivery in 124 women: Impact of prior peritoneal > closure at > primary cesarean on the interval time between first cesarean > section and > the next pregnancy and significant adhesion at second > cesarean.Komoto Y, > Shimoya K, Shimizu T, Kimura T, Hayashi S, Temma-Asano K, > Kanagawa T, > Fukuda H, Murata Y. > Department of Obstetrics and Gynecology, Osaka University Graduate > School of Medicine, Suita, Osaka, Japan. > > AIM: The aim of this study was to evaluate the effect of non- > closure of > the peritoneum at cesarean delivery on postoperative > complications and > the interval time to the next pregnancy, and to investigate the > incidence of adhesion following cesarean and the association between > adhesion formation and peritoneal closure. METHODS: One > hundred and > twenty four women scheduled for cesarean section were randomized to > either closure of both the visceral and parietal peritoneum (C- > group, n > = 70) or non-closure (NC-group, n = 54). At repeated > cesarean, the > levels and extent of adhesion, operating time, and any complications > were examined. RESULTS: There was no difference in the > incidence of > postoperative complications at the first cesarean section. The > operating time of the C-group was significantly longer than that > of the > NC-group. The frequency of analgesic use was significantly > higher in > the C-group. The time interval from cesarean section to > the next > pregnancy in the NC-group was significantly shorter than that in the > C-group. There are no significant differences between the > rates of > complications in the C-group and the NC-group at repeated > cesarean. The > incidence of adhesion in the C-group was significantly higher > than that > in the NC-group (P < 0.05). The mean total operating > time and the mean > interval time for skin incision to delivery in the C-group were > significantly longer than those in the NC-group (P < 0.05 and > P < 0.001, > respectively) at repeated cesarean section. CONCLUSIONS: > Non-closure of > the peritoneum at cesarean delivery appears to have no adverse > effect on > postoperative recovery, it also decreases the number of > analgesic doses > and shortens the operating time and may be more desirable in > achieving a > next pregnancy. The present study demonstrated that > surgical peritoneal > closure resulted in more advanced adhesion formation. The > practice of > non-closure of the peritoneum should be performed at cesarean. > > -- > Take care, John >

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<DIV>thanks for this article.</DIV> <DIV>I shall continue to non-close the peritoneum</DIV>

><DIV>frances wren ----- Original Message ----- From: johnprov@sympatico.ca (Dr. John Provatopoulos  B.Sc. M.D.C.M. F.R.S.C.) Date: Thursday, March 6, 2008 8:55 pm Subject: Re: =?ISO-8859-9?Q?Re:_Yanýt:_peritoneum?In-Reply-To: <6378.55172.qm@web33204.mail.mud.yahoo.com> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net> > J Obstet Gynaecol Res. 2006 Aug;32(4):396-402. Links > Prospective study of non-closure or closure of the peritoneum at > cesarean delivery in 124 women: Impact of prior peritoneal > closure at > primary cesarean on the interval time between first cesarean > section and > the next pregnancy and significant adhesion at second > cesarean.Komoto Y, > Shimoya K, Shimizu T, Kimura T, Hayashi S, Temma-Asano K, > Kanagawa T, > Fukuda H, Murata Y. > Department of Obstetrics and Gynecology, Osaka University Graduate > School of Medicine, Suita, Osaka, Japan. > > AIM: The aim of this study was to evaluate the effect of non- > closure of > the peritoneum at cesarean delivery on postoperative > complications
and > the interval time to the next pregnancy, and to investigate the > incidence of adhesion following cesarean and the association between > adhesion formation and peritoneal closure.  METHODS: One > hundred and > twenty four women scheduled for cesarean section were randomized to > either closure of both the visceral and parietal peritoneum (C- > group, n > = 70) or non-closure (NC-group, n = 54).  At repeated > cesarean, the > levels and extent of adhesion, operating time, and any complications > were examined.  RESULTS: There was no difference in the > incidence of > postoperative complications at the first cesarean section.  The > operating time of the C-group was significantly longer than that > of the > NC-group.  The frequency of analgesic use was significantly > higher in > the C-group.  The time interval from cesarean section to > the next > pregnancy in the NC-group was significantly shorter than that in the > C-group.  There are no significant differences between the > rates of > complications in the C-group and the NC-group at repeated > cesarean.  The > incidence of adhesion in the C-group was significantly higher > than that > in the NC-group (P < 0.05).  The mean total operating > time and the mean > interval time for skin incision to delivery in the C-group were > significantly longer than those in the NC-group (P < 0.05 and > P < 0.001, > respectively) at repeated cesarean section.  CONCLUSIONS: > Non-closure of > the peritoneum at cesarean delivery appears to have no adverse > effect on > postoperative recovery, it also decreases the number of > analgesic doses > and shortens the operating time and may be more desirable in > achieving a > next pregnancy.  The present study demonstrated that > surgical peritoneal > closure resulted in more advanced adhesion formation.  The > practice of > non-closure of the peritoneum should be performed at cesarean. > > -- >                               &nbsp&# 059;  Take care, John > </DIV>

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