Abdominal Adhesiolysis: Inpatient Care and Expenditures in the United States in 1994

Ray, Nancy; Denton, William G.; Thamer, Mae; Henderson, Scott C.; Perry, Seymour

doi:10.1016/s1072-7515(97)00127-0

Cited by 473 publications

(271 citation statements)

References 14 publications

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“…[2] This widespread condition therefore represents a tremendous financial burden to health services, in terms of time a relaparotomy and the cost of treating adhesion complications. [4] However, despite their clinical importance, information regarding the molecular and cellular events regulating adhesion formation is limited, and current prevention is based on careful surgery and the occasional use of physical barriers that are effective in only a proportion of patients.…”

Section: Resultsmentioning

confidence: 99%

Evaluation of agar films in prevention of postoperative peritoneal adhesions in animal model

Mamoudieh¹,

Mirkheshti²,

Alavi³

2011

Ulus Travma Acil Cerrahi Derg

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AMAÇPeritoneal yapışıklıkları uzun sürede önemli postoperatif morbidite nedenidir. Bu çalışma, bir hayvan modelinde karın cerrahisinden sonra yapışıklık oluşumunun azaltılma-sında agar plakalarının etkinliğini değerlendirmektedir. GEREÇ VE YÖNTEMYapışıklıklar bir laparotomi işlem sırasında 20 C57/BL6 farelerde, çekum abrazyonuyla oluşturuldu. Deneysel grup şeklinde 10 farede agar plakaları kullanıldı, 28 gün sonraki ikinci operasyonda, yapışıklıklar iki grupta derecelendirildi. Veriler, Student t testi kullanılarak analiz edildi. BULGULARÇalışma süresince iki grubun kilosu açısından anlamlı bir fark yoktu. Yapışıklıkların morfolojik görünüm karşılaş-tırmasında, iki grup arasında belirgin bir fark yoktu. Aynı zamanda, iki grup arasında yapışıklıkların insidans oranı veya cerrahi işlem sonrası adezyon skorları bakımından da hiçbir anlamlı fark yoktu (p>0,05). SONUÇSahip olduğu hidrojel özelliklerine karşın, agar, uygulamada peritoneal cerrahiden sonraki yapışıklık oluşumunun azaltılmasında başarılı olmamıştır. Biyolojik bir ürün olması nedeniyle, agar, peritondaki doğal immün sistem tarafın-dan uyarılan bir hiperreaktiviteye yol açabilir. Bu yüzden, agar, klinik uygulamada peritoneal cerrahiden sonra yapı-şıklık oluşumunun azaltılmasına yönelik olarak yararlı gibi görünmemektedir.

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Section: Resultsmentioning

confidence: 99%

Evaluation of agar films in prevention of postoperative peritoneal adhesions in animal model

Mamoudieh¹,

Mirkheshti²,

Alavi³

2011

Ulus Travma Acil Cerrahi Derg

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“…The costs of all hospitalisations for adhesiolysis in the United States in 1994 were estimated to be around €1 billion (US $1.33 billion), of which approximately €596 million (US $764 million) was for hospitalisations directly attributable to adhesions [72].…”

Section: The Cost Of Adhesionsmentioning

confidence: 99%

Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position

DeWilde

Trew

2007

Gynecol Surg

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Adhesions are the most frequent complication of abdominopelvic surgery, yet many surgeons are still not aware of the extent of the problem and its serious consequences. While adhesions may cause few or no detrimental effects to patients, in a considerable proportion of cases there are major short-and long-term consequences, including small-bowel obstruction, infertility and chronic pelvic pain. Adhesions complicate future surgery with important associated morbidity and expense-and a considerable risk of mortality. Despite advances in surgical techniques in recent years, the burden of adhesion-related complications has not changed. Adhesions should now be considered the most common complication of abdominopelvic surgery. Adhesiolysis remains the main treatment, despite the fact that adhesions reform in most patients. Developments in adhesion-reduction strategies and new agents now offer a realistic possibility of reducing the risk of adhesions forming and can improve the outcomes for patients and the associated onward burden. This consensus position represents the collective views of 35 gynaecologists with a recognised interest in adhesions. The position is presented in two parts. The first part reviews the published literature on the extent of the problem of adhesions, and the second part considers the opportunities to reduce their incidence. It also provides collective proposals on the actions that European gynaecologists should take to avoid causing adhesions. Importantly it also advises that it is now time to inform patients of the risks associated with adhesion-related complications during the consent process. With increasing evidence to support the efficacy of adhesion-reduction agents to complement good surgical practice, all surgeons should act now to reduce adhesions and fulfil their duty of care to patients.

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“…For example in 1994, the estimated financial impact for direct patient care owing to adhesions related disorders in the United States of America was 1.3 billion US$, while in Sweden, it is estimated that health care burden owing to adhesive disease reaches 13 million US$ annually (7,8).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Post Operative Peritoneal Lavage to Prevent Recurrent Adhesive Intestinal Obstruction

Saady

Metwally

Hefny

et al. 2017

Zagazig University Medical Journal

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Objective: to evaluate the effectiveness of postoperative peritoneal lavage (PPL) in prevention of recurrent Adhesive Small Bowel Obstruction (ASBO).Patients and methods: a total of 36 patients were included in this study. All of these patients suffered from ASBO. They were randomized into two groups. Group I (18 patients) were treated with adhesiolysis followed by PPL and group II (18 patients) were treated with adhesiolysis alone . Patients w e r e followed up for an average period of 15 months to detect the incidence of recurrent ASBO. Results: :In group1 only one (5.6%) patient had an attack of ASBO which responded to conservative management and did not need redo operation while in group II s e v e n ( 3 8 . 9 % ) p a t i e n t s developed a recurrent episode of ASBO f o u r o f t h e m ( 2 2 . 2 % ) n e e d e d s u r g i c a l r e e x p l o r a t i o n . So the rate of surgical reoperation in group 1 was zero in comparison to group 2 which was( 16.6%). Conclusion: PPL is a new hope for prevention of recurrent ASBO that achieved statistically significant reduction in the recurrence rate and surgical redo.

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Abdominal Adhesiolysis: Inpatient Care and Expenditures in the United States in 1994

Cited by 473 publications

References 14 publications

Evaluation of agar films in prevention of postoperative peritoneal adhesions in animal model

Evaluation of agar films in prevention of postoperative peritoneal adhesions in animal model

Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position

Evaluation of Post Operative Peritoneal Lavage to Prevent Recurrent Adhesive Intestinal Obstruction

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