Help
Subscribe


Submit Videos to GastroHep Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Burden of adhesions in abdominal and pelvic surgery

This week's issue of the British Medical Journal reviews the burden of adhesions in abdominal and pelvic surgery.

News image

Dr Richard ten Broek and colleagues estimated the disease burden of the most important complications of postoperative abdominal adhesions, including small bowel obstruction, difficulties at reoperation, infertility, and chronic pain.

The team performed a systematic review of articles published in PubMed, Embase, and Central, from 1990 to 2012, without restrictions to publication status or language.

All types of studies reporting on the incidence of adhesion related complications were considered.

Data extraction and analysis The primary outcome was the incidence of adhesive small bowel obstruction in patients with a history of abdominal surgery.

The team's secondary outcomes were the incidence of small bowel obstruction by any cause, difference in operative time, enterotomy during adhesiolysis, and pregnancy rate after abdominal surgery.

Subgroup and sensitivity analyses were done to study the robustness of the results.

A random effects model was used to account for heterogeneity between studies.

The incidence of adhesive small bowel obstruction was 2%
British Medical Journal

The research team identified 196 eligible papers.

Heterogeneity was considerable for almost all meta-analyses.

The origin of heterogeneity could not be explained by study design, study quality, publication date, anatomical site of operation, or operative technique. The incidence of small bowel obstruction by any cause after abdominal surgery was 9%.

The research team found that the incidence of adhesive small bowel obstruction was 2%.

The team noted that the presence of adhesions was generally confirmed by emergent reoperation.

In patients with a known cause of small bowel obstruction, adhesions were the single most common cause.

Operative time was prolonged by 15 minutes in patients with previous surgery.

The researchers observed that the use of adhesiolysis resulted in a 6% incidence of iatrogenic bowel injury.

The pregnancy rate after colorectal surgery in patients with inflammatory bowel disease was 50%, which was significantly lower than the pregnancy rate in medically treated patients.

Dr ten Broek's team commented, "This review provides detailed and systematically analysed knowledge of the disease burden of adhesions."

"Complications of postoperative adhesion formation are frequent, have a large negative effect on patients’ health, and increase workload in clinical practice."

"The quantitative effects should be interpreted with caution owing to large heterogeneity."

BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f5588
22 October 2013

Go to top of page Email this page Email this page to a colleague

 31 July 2014

Advanced search
 31 July 2014 
Diverticular disease and colon cancer
 31 July 2014 
Biomarkers in liver fibrosis
 31 July 2014 
Risk factors of large colorectal polyps
 30 July 2014 
Small intestinal permeability in diarrhea predominant IBS
 30 July 2014 
Mineral rich water and constipation
 30 July 2014 
Interval between screening colonoscopies
 29 July 2014 
Fluticasone in eosinophilic esophagitis
 29 July 2014 
Causes of GI bleeding in cirrhosis
 29 July 2014 
ALT increases in Hep B
 28 July 2014 
Statins reduce Barrett's
 28 July 2014 
Score predicts risk for Barrett’s esophagus
 28 July 2014 
Gastric cancer prevention
 25 July 2014 
De-escalation of therapy in IBD
 25 July 2014 
Bionic pancreas in type 1 diabetes
 25 July 2014 
Primary care physician counselling and colonoscopy
 24 July 2014 
Diagnostic tool for obscure-overt GI bleeding
 24 July 2014 
Statin use and Barrett’s esophagus
 24 July 2014 
Atopy and functional GI disorders
 23 July 2014 
Sofosbuvir and ribavirin for Hep C
 23 July 2014 
Early corticosteroids after the diagnosis of ulcerative colitis
 23 July 2014 
C-section and IBD risk
 22 July 2014 
Thromboembolism in IBD
 22 July 2014 
Alcohol and colorectal adenoma risk
 22 July 2014 
Cognitive behavioral therapy in IBS
 21 July 2014 
Stents to prevent post-ERCP pancreatitis
 21 July 2014 
Psychometric validation of IBS symptom severity
 21 July 2014 
Mortality in IBD
 18 July 2014 
Treatment of enteropancreatic neuroendocrine tumors
 18 July 2014 
Ulcer complications and dyspeptic symptoms
 18 July 2014 
ERCP with overtube-assisted enteroscopy
 17 July 2014 
Treatment of H. pylori
 17 July 2014 
Ultrasound for diagnosis of gastric varices
 17 July 2014 
Small intestinal permeability in diarrhea predominant IBS
 16 July 2014 
Mortality after colectomy in IBD
 16 July 2014 
Esophageal cancer missed at endoscopy
 16 July 2014 
Screening for Hepatitis B
 15 July 2014 
Diagnosing diverticulitis
 15 July 2014 
Variation in management decisions for colorectal cancer
 15 July 2014 
Muscle cramps in cirrhosis
 14 July 2014 
Predicting the course of ulcerative colitis
 14 July 2014 
Choice in colorectal cancer screening tests
 14 July 2014 
Adhesions in abdominal surgery
 11 July 2014 
Temporal evolution of antidrug antibodies in IBD
 11 July 2014 
Atopy and functional gastrointestinal disorders
 11 July 2014 
Fecal microbiota transplant for C. diff
 10 July 2014 
Acid-suppressive medications and cancer risk in Barrett's
 10 July 2014 
Personalized medicine in the management of IBD
 10 July 2014 
Pregnancy outcome in anti-TNF treated women with IBD
 09 July 2014 
Quality of care provided to patients with varices
 09 July 2014 
Eosinophilic esophagitis and celiac disease
 09 July 2014 
Diagnosis and management of adult celiac disease
 08 July 2014 
Screening for Hep B
 08 July 2014 
NSAID-induced small intestinal injury
 08 July 2014 
Drug-induced liver injury
 07 July 2014 
Obesity and complications after lapaproscopic colorectal surgery
 07 July 2014 
Everolimus and advanced hepatocellular carcinoma
 07 July 2014 
Pediatric celiac disease risk factors
 04 July 2014 
Day-case vs inpatient laparoscopic fundoplication
 04 July 2014 
Alcohol assessment in liver transplant
 04 July 2014 
Clinical competence in colorectal cancer surgery

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us