Adhesion-related readmissions following gynaecological laparoscopy or laparotomy in Scotland: an epidemiological study of 24 046 patients

Lower, A.M.; Hawthorn, Robert; Clark, David; Boyd, James H.; Finlayson, Alan; Knight, A.; Crowe, A. M.

doi:10.1093/humrep/deh321

Cited by 164 publications

(138 citation statements)

References 17 publications

Supporting

Mentioning

124

Contrasting

Unclassified

Order By: Relevance

“…Surgeons participating in the inclusion of patients in the COLOR trial had all performed 20 laparoscopic colonic resections before entering the trial. The protocol for the COLOR trial was approved by the appropriate ethics committee of each participating institution before its entry into the trial, and the details of inclusion, exclusion, and consent have been described [12]. Patients were included in the trial according to the inclusion and the exclusion criteria, and of the initially 1,248 included patients 1,083 patients were left for follow-up, as described [19].…”

Section: Methodsmentioning

confidence: 99%

“…In an experimental model in pigs, it was reported recently that the incidence of intra-abdominal adhesions was lower after laparoscopic compared with open cholecystectomy [11]. It has been reported that open and laparoscopic surgery are associated with comparable risks of adhesion-related readmissions after gynecological surgery [12]. Hypothetically the minimally invasive techniques may result in less adhesion formation compared with open techniques.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Bowel obstruction after laparoscopic and open colon resection for cancer: Results of 5 years of follow-up in a randomized trial

et al. 2011

View full text Add to dashboard Cite

Background Postoperative bowel obstruction caused by intra-abdominal adhesions occurs after all types of abdominal surgery. It has been suggested that the laparoscopic technique should reduce the risk for adhesion formation and thus for postoperative bowel obstruction. This study was designed to compare the incidence of bowel obstruction in a randomized trial where laparoscopic and open resection for colon cancer was compared. Methods A retrospective analysis was performed, collecting data of episodes of bowel obstruction with or without surgery. Only episodes treated in the hospital where the index surgery took place were included. Data for 786 patients were collected for the 5-year period after cancer surgery. Results Baseline characteristics for the evaluated laparoscopic (n = 383) and open (n = 403) groups were comparable. The cumulative obstruction percentages at 5 years for the open and laparoscopic groups were 6.5 and 5.1% respectively and did not significantly differ from each other. Tumor stage seemed to influence the risk for bowel obstruction: 2.8% in stage I, 6.6% in stage II, and 7% in stage III, but the differences were not significant. Conclusions This analysis does not support the hypothesis that laparoscopy leads to fewer episodes of bowel obstruction compared with open surgery.Surgical trauma is the cause of more than 90% of intraabdominal adhesions, and approximately 30% of patients who undergo major surgery develop postoperative

show abstract

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Bowel obstruction after laparoscopic and open colon resection for cancer: Results of 5 years of follow-up in a randomized trial

et al. 2011

View full text Add to dashboard Cite

show abstract

“…The SCAR group subsequently reported that for therapeutic and diagnostic laparoscopic procedures (i.e. all laparoscopic procedures undertaken with the exception of low-risk tubal sterilisations), the risk of adhesion-related readmission was comparable to that of gynaecological laparotomy [5]. The group concluded that despite advances in surgical technique, the burden of adhesion-related readmissions continues.…”

Section: The Epidemiology and Clinical Importance Of Adhesionsmentioning

confidence: 99%

“…Despite advances in surgical techniques in recent years, the burden of adhesion-related complications has not changed [4,5]. While laparoscopic procedures are commonly believed to be less adhesiogenic and cause fewer de novo adhesions to form compared to open surgery [6,7], for many procedures, the comparative risk of adhesion-related complications following open and laparoscopic gynaecological surgery is similar [5].…”

Section: Introductionmentioning

confidence: 99%

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

DeWilde

Trew

2007

Gynecol Surg

View full text Add to dashboard Cite

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.

show abstract

“…The most common site of postoperative adhesions formation is between the ovary and the pelvic wall [12]. Notwithstanding the advances in surgical techniques [13] and the use of surgical anti-adhesive agents, the incidence of adhesion-related complications do not seem to have significantly declined [14].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of ovarian suspension to round ligament with a resorbable suture to prevent postoperative adhesions in women with ovarian endometrioma: follow-up by transvaginal hydrolaparoscopy

et al. 2014

View full text Add to dashboard Cite

The aim of this study was to assess the effect of ovarian suspension to the round ipsilateral ligament with a resorbable suture, performed during laparoscopic surgery for endometrioma, on postoperative ovarian adhesion formation. The tool used to assess this effect was not conventional laparoscopy but outpatient transvaginal hydrolaparoscopy. Fifty women with single ovarian endometrioma were divided in two groups (group A, 24 and group B, 26). All patients underwent laparoscopic ovarian cystectomy for endometriosis. In group A, the ovary was suspended to the ipsilateral round ligament. In group B, ovarian suspension was not performed. All patients underwent transvaginal outpatient hydrolaparoscopy as follow-up. A significantly lower rate of postsurgical ovarian adhesion in group A in comparison with group B (33.3 vs 80.8 %-p=0.001) was observed. Operative time and postoperative pain were similar in both groups. Ovarian suspension to the ipsilateral round ligament with a resorbable suture during surgery for endometrioma is associated with a lower rate of postoperative ovarian adhesion formation.

show abstract

Adhesion-related readmissions following gynaecological laparoscopy or laparotomy in Scotland: an epidemiological study of 24 046 patients

Abstract: With the exception of laparoscopic sterilizations, open and laparoscopic gynaecological surgery are associated with comparable risks of adhesion-related readmissions.

Cited by 164 publications

References 17 publications

Bowel obstruction after laparoscopic and open colon resection for cancer: Results of 5 years of follow-up in a randomized trial

Bowel obstruction after laparoscopic and open colon resection for cancer: Results of 5 years of follow-up in a randomized trial

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

Efficacy of ovarian suspension to round ligament with a resorbable suture to prevent postoperative adhesions in women with ovarian endometrioma: follow-up by transvaginal hydrolaparoscopy

Contact Info

Product

Resources

About