title: Postoperative adhesion development after operative laparoscopy: evaluation at early second-look procedures. Operative Laparoscopy Study Group.
abstract: To assess the issue of the frequency and severity of adhesion reformation and de novo adhesion formation after operative laparoscopy, this multicenter collaborative report of early second-look procedures after operative laparoscopy was initiated. Sixty-eight subjects underwent operative laparoscopic procedures including adhesiolysis, followed by a second operative procedure within 90 days. The total mean adhesion score decreased from 11.4 +/- 0.7 at the initial operative procedure to 5.5 +/- 0.4 at the second-look procedure, a decrease of 52%. At the time of the second-look procedure, 66 of 68 women (97.1%) had pelvic adhesions. Adhesion reformation occurred in 66 of 68 women and at 230 of 351 sites (66%) at which adhesions were lysed. Despite this high incidence of adhesion reformation, de novo adhesion formation after operative laparoscopy occurred in only 8 of 68 women (12%) and at 11 of 47 available sites in these 8 women. We conclude that adhesion reformation is a frequent occurrence after operative laparoscopy; however de novo adhesion formation appears to occur much less frequently.
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000601:surgery*; D010535:Laparoscopy; D010053:Ovary / Q000601:surgery; D010388:Pelvis; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation; D013997:Time Factors; D000267:Tissue Adhesions / Q000209:etiology* / Q000473:pathology / Q000601:surgery