Laparoscopic Adhesiolysis in Chronic Abdominal Pain

Paajanen, Paavo; Fagerström, Anne; Paajanen, Hannu

doi:10.1097/mcg.0000000000000787

Cited by 6 publications

(8 citation statements)

References 19 publications

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“…In contrast, other studies have reported that pain reduction does not differ between laparoscopic adhesiolysis and diagnostic laparoscopy alone and therefore they did not recommend laparoscopic adhesiolysis as a treatment for adhesions in patients with chronic abdominal pain [31, 32]. In carefully selected patients with chronic abdominal pain, the positive effects of laparoscopic adhesiolysis can be sustained beyond 15 years after the surgery [33]. In one study, some patients (43%) underwent repeat adhesiolysis because of pain aggravation [14], and it took approximately 6 months for the pain to decrease from an average preoperative score of 8 to a postoperative score of 2 [15].…”

Section: Discussionmentioning

confidence: 99%

Adhesion-induced chronic abdominal pain: a case report on the diagnostic value of Carnett’s test

et al. 2019

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Background Chronic abdominal pain is a common clinical problem. However, diagnosing chronic abdominal pain often requires detailed diagnostic evaluations in addition to sufficient history taking and physical examination, owing to its uncertain etiology. Case presentation We report a case of a 36-year-old man with chronic abdominal pain originating from postoperative adhesions. Postoperative adhesions are common phenomena, and abdominal surgery can cause severe abdominal pain, the source of which can be difficult to detect. Carnett’s test is useful to detect abdominal wall tenderness and to determine the affected abdominal quadrant. Incorporating its use with a detailed chronological clinical history contributes to the improvement of diagnostic accuracy. In addition to the above-mentioned information, attention to subtle imaging findings may provide greater diagnostic accuracy. Conclusions Abdominal pain induced by postoperative adhesions was reduced by laparoscopic adhesiolysis. Carnett’s test is an effective tool for evaluating pain and detecting its cause. Electronic supplementary material The online version of this article (10.1186/s13256-019-2026-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Adhesion-induced chronic abdominal pain: a case report on the diagnostic value of Carnett’s test

et al. 2019

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“…There were no significant differences among the two groups concerning the rate of intraoperative bowel injury, the occurrence of wound infection, or mortality. In a study comparing laparotomy with laparoscopy in 9619 patients with small-bowel obstruction demanding adhesiolysis, Kelly et al described that at 30 days, the patients in the laparoscopic adhesiolysis group had lesser rates of major complications and incisional complications than those in the open group, in addition to decreased mortality (1.3% vs 4.7%) [16] . In a nonrandomized follow-up of 68 patients over 15 years, Paajanen et al determined that adhesiolysis had a long-term positive effect, but even though patients experienced pain relief they still had other abdominal symptoms [17] .…”

Section: Discussionmentioning

confidence: 99%

“…This may require working proximally and distally to the zone of worry before moving toward the reasonable region of hindrance. The reasonable region of deterrent will have enlarged gut proximally and decompressed inside distally [16,19] .…”

Section: Adhesiolysis Technique  Open Approach To Abdominal Adhesionsmentioning

confidence: 99%

Laparoscopic versus Open Adhesiolysis in Patients with Bowel Obstruction

Otaibi¹,

Saleh²,

Sabbahi³

2018

Egyptian Journal of Hospital Medicine

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Background: Adhesions are bands of scar tissue that form between organs. In the abdomen, they form after an abdominal surgery or after a bout of intra-abdominal infection (i.e., pelvic inflammatory disease, diverticulitis). More than 95% of patients who undergo abdominal surgery develop adhesions; these are nearly inevitably part of the body's healing process. Though most adhesions are asymptomatic, some can cause bowel obstructions, infertility, and chronic pain. Objectives: Concerning whether patients with chronic pelvic pain benefit from laparoscopic adhesiolysis or whether any appearing advantage is a placebo effect. Materials and methods: This review was conducted using a comprehensive search of MEDLINE, PubMed,

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“…Thus, laparoscopic adhesiolysis has also become popular and widely studied. [2][3][4][5] In general, the laparoscopic procedure has many benefits compared to open surgery including less postoperative pain, early recovery, and fewer complications in many fields of intra-abdominal surgery. 4,6,7 However, questions remain regarding whether these advantages could be adopted to laparoscopic adhesiolysis for SBO.…”

Section: Introductionmentioning

confidence: 99%

Does Laparoscopic Adhesiolysis Reduce the Risk of Small Bowel Obstruction Related Readmissions and Reoperations Compared to Open Adhesiolysis?

Park

Kim

Park

2020

J Minim Invasive Surg

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The present study aimed to assess the safety and efficacy of laparoscopic adhesiolysis in decreasing recurrent episodes of small bowel obstruction (SBO) compared to that of the conventional open procedure.Methods: Among 373 patients who visited our emergency department from January 2000 to July 2018 due to small bowel obstruction, 67 patients who underwent adhesiolysis were included in this study. Eighteen and 49 patients comprised the open adhesiolysis (OA) and laparoscopic adhesiolysis (LA) groups, respectively. Clinical demographics, computed tomography (CT) findings, laboratory results, and perioperative outcomes were compared. Further, the long-term follow-ups of SBO related re-admissions and re-operations were also compared. Results:Preoperative baseline data, pain characteristics, laboratory findings, and ileus-related CT findings showed no significant difference between the two groups. LA was related to less blood loss and complications, along with early bowel movement recovery. Similarly, fewer SBO-related re-admissions [OA vs. LA=8 (44.4%) vs. 3 (6.1%), p=0.001] and re-operations [OA vs. LA=3 (16.7%) vs. 1 (2.0%), p=0.025] were observed in LA compared to OA. Conclusion:LA is a safer and more feasible procedure for SBO treatment compared to OA. This procedure showed a reduction in SBO-related re-admission and re-operation rates.

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Laparoscopic Adhesiolysis in Chronic Abdominal Pain

Abstract: In carefully selected patients suffering from chronic abdominal pain, the positive effect of laparoscopic adhesiolysis stands beyond 15 years after the surgery. Although the patients reported relief of pain they still had various abdominal symptoms.

Cited by 6 publications

References 19 publications

Adhesion-induced chronic abdominal pain: a case report on the diagnostic value of Carnett’s test

Adhesion-induced chronic abdominal pain: a case report on the diagnostic value of Carnett’s test

Laparoscopic versus Open Adhesiolysis in Patients with Bowel Obstruction

Does Laparoscopic Adhesiolysis Reduce the Risk of Small Bowel Obstruction Related Readmissions and Reoperations Compared to Open Adhesiolysis?

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