Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 02 May 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy 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

 02 May 2016 
Resection of colorectal polyps
 02 May 2016 
Genetic variant that increase NAFLD risk
 02 May 2016 
Mycophenolate mofetil as first-line treatment of autoimmune hepatitis
 29 April 2016 
Crohn's disease associated genes
 29 April 2016 
Simvastatins and survival in cirrhosis
 29 April 2016 
HCV infection in Baby Boomers with Medicare
 28 April 2016 
Diarrheal diseases in children
 28 April 2016 
Racial disparities in survival from colon cancer
 28 April 2016 
Birth outcomes in women with IBD receiving assisted reproduction
 27 April 2016 
Dust mite and human GI tract
 27 April 2016 
Celiac disease in adults
 27 April 2016 
Ultra-short celiac disease
 26 April 2016 
Guidelines for nutrition therapy in hospitalized patients
 26 April 2016 
IBS and microscopic colitis
 26 April 2016 
Polyp detection during colonoscopy
 25 April 2016 
Estrogen deficiency and fibrosis risk in women with NAFLD
 25 April 2016 
Acceptance of Liver transplant center organ offers
 25 April 2016 
Abrupt interruption of beta-blockers in cirrhosis 
 22 April 2016 
Novel method to regenerate the esophagus
 22 April 2016 
Relapse after antiviral treatment in Hep B
 22 April 2016 
Microscopic colitis with NSAIDs and PPIs
 11 April 2016 
Admissions times and outcomes for ERCP cholangitis
 11 April 2016 
Infliximab vs adalimumab in ulcerative colitis
 11 April 2016 
H. pylori in treatment-naïve children
 08 April 2016 
Endoscopic treatment of Crohn's strictures
 08 April 2016 
Nutrition therapy in the hospitalized patient
 08 April 2016 
H.pylori effects on pediatric gastric mucosa
 07 April 2016 
CVD changes after TIPSS
 07 April 2016 
HBV during immunosuppressive therapies
 07 April 2016 
Transanal mesorectal resection for rectal cancer
 06 April 2016 
Adherence to colorectal cancer screening strategies
 06 April 2016 
Duodenal bulb biopsies in childhood celiac disease diagnosis
 06 April 2016 
Lymph node metastasis in early gastric cancer
 05 April 2016 
IBS in the US military
 05 April 2016 
Changes in blood flow in cirrhosis
 05 April 2016 
Colorectal cancer risk with serrated polyps
 04 April 2016 
Noninvasive diagnosis of celiac disease
 04 April 2016 
Metallic vs plastic stents for benign biliary strictures
 04 April 2016 
Adherence to quality indicators improves clinical outcomes in ascites
 01 April 2016 
Prognosis after colorectal cancer resection with peritoneal metastasis
 01 April 2016 
Colorectal cancer risk with non-malignant colonoscopy findings
 01 April 2016 
Intensive enteral nutrition and severe alcoholic hepatitis
 31 March 2016 
Anesthesia services during colonoscopy
 31 March 2016 
Alcohol and glucose tolerance in NAFLD
 31 March 2016 
Management of Barrett’s esophagus
 30 March 2016 
Depression and symptoms in IBS
 30 March 2016 
Electronic learning system for colon capsule endoscopy
 30 March 2016 
Gastric cancer screening
 29 March 2016 
Statins and survival in esophageal cancer
 29 March 2016 
Infant feeding practices and celiac disease
 25 March 2016 
Medical therapy and neoplasia regression in familial adenomatous polyposis
 25 March 2016 
Medical therapy compliance and ulcerative colitis recurrence
 25 March 2016 
Predicting outcomes of drug-induced acute liver failure
 24 March 2016 
Thrombocytopenia and multi-organ system failure in acute liver failure
 24 March 2016 
Patients with ulcerative colitis and their concerns
 24 March 2016 
Prediction of relapses in IBD
 23 March 2016 
Thiopurine therapy in IBD
 23 March 2016 
Early colonoscopy for lower GI bleeds
 23 March 2016 
Treatment with immunomodulators and biologics in ulcerative colitis
 22 March 2016 
Bile acid diarrhea

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us