Laparoscopic adhesiolysis for chronic abdominal pain: an objective assessment.
OBJECTIVE
Postoperative adhesions frequently occur and can account for various symptoms, including chronic abdominal pain. Conventional adhesiolysis by laparotomy results in an unacceptably high rate of recurrence. A minimally invasive procedure (laparoscopic adhesiolysis) might improve the outcome by inflicting less surgical trauma, but well-documented reports focused on laparoscopic adhesiolysis for chronic abdominal pain are lacking.


METHODS
Twelve consecutive patients with chronic abdominal pain caused by adhesions who were treated by laparoscopic adhesiolysis were assessed preoperatively and during a 1-year follow-up period applying validated scoring systems: McGill and SLC-90 tests to evaluate personalities and MOS SF-36 and GIQLI questionnaires for the quality of life assessments.


RESULTS
No psychological influences were identified. Only two patients experienced a lasting improvement in quality of life, and five patients had more or less stable complaints. Five patients required laparotomy within a year after laparoscopic adhesiolysis.


CONCLUSIONS
Laparoscopic adhesiolysis has yet not passed the stage of clinical trial and requires objective evaluation, including detailed information on recurrence and de novo adhesions in correlation with clinical outcome.
Bremers
A J
AJ
Department of Surgery, Leiden University Medical Center, The Netherlands. bremersklaver@noknok.nl
Ringers
J
J
Vijn
A
A
Janss
R A
RA
Bemelman
W A
WA
D015746:Abdominal Pain / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D011788:Quality of Life; D000267:Tissue Adhesions / Q000601:surgery*