Incidence of intraabdominal adhesions in a continuous series of 1000 laparoscopic procedures.
OBJECTIVE
The objective of the study was the laparoscopic evaluation of the incidence of intraabdominal adhesions related to prior abdominal surgery.


METHODS
This was a prospective monocentric study including a continuous series of 1000 gynecologic laparoscopic procedures. Data were collected on history of abdominal surgery. A precise initial description of intraoperative adhesions was performed.


RESULTS
Six hundred thirty-seven of the 1000 procedures (63.7%) were performed in patients with a history of 1 or more than 1 abdominal surgery. Intraoperative adhesions were found in 211 of the 1000 subjects (21.10%). Fifty-nine of the 211 cases (28%) involved bowel loops. The prior indication for surgery did not seem to influence adhesion formation. The rate of intestinal adhesions significantly increased with the number of prior abdominal surgeries. The rate of intestinal adhesions was significantly higher in cases of prior midline incisions in comparison with the other incisions.


CONCLUSIONS
Extensive preoperative knowledge of prior surgery is essential to evaluate the risk of adhesion formation.
Department of Obstetrics and Gynecology, Polyclinique, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France. neajdubuisson@yahoo.fr
Jean
J
Dubuisson
Revaz
R
Botchorishvili
Sandrine
S
Perrette
Nicolas
N
Bourdel
Kris
K
Jardon
Benoît
B
Rabischong
Michel
M
Canis
Gérard
G
Mage
D034841:Abdominal Cavity / Q000601:surgery*; D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D015994:Incidence; D007410:Intestinal Diseases / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D007813:Laparotomy / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011336:Probability; D011446:Prospective Studies; D012086:Reoperation; D018570:Risk Assessment; D000267:Tissue Adhesions / Q000453:epidemiology* / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome