A prospective analysis of predictive factors on the results of laparoscopic adhesiolysis in patients with chronic abdominal pain.
Laparoscopic adhesiolysis for chronic abdominal pain is subject for criticism. In this prospective study, we analyze factors that encourage or discourage the indication for therapeutic laparoscopic adhesiolysis. Two hundred twenty-four consecutive patients with chronic abdominal pain underwent diagnostic laparoscopy, and in case of adhesions, they underwent adhesiolysis. Pain relief was assessed, and the individual impact of variables on pain relief was determined. Laparoscopy was performed in 224 patients. Two hundred patients had only adhesions and underwent primary laparoscopic adhesiolysis. Three months after adhesiolysis, 74% of patients were pain-free or had less pain. The remaining 26% of the patients felt no change (22%) or had more pain (4%). Gender, age, and bowel perforation leading to a laparotomy appear to be individual factors significantly influencing pain relief. Laparoscopic adhesiolysis can be done (almost) completely in 92% of patients with adhesions. After laparoscopic adhesiolysis, 74% of patients had good results and 4% had more pain. The complication rate is high.
Swank
Dingeman J
DJ
Department of Surgery, Groene Hart Hospital, Gouda. djswank@xs4all.nl
Van Erp
Willem F M
WF
Repelaer Van Driel
Ocker J
OJ
Hop
Wim C J
WC
Bonjer
H Jaap
HJ
Jeekel
Hans
H
D015746:Abdominal Pain / Q000209:etiology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D011379:Prognosis; D011446:Prospective Studies; D000267:Tissue Adhesions / Q000175:diagnosis / Q000601:surgery*