Help
Subscribe


All of GastroHep is now free access! - Click here to register 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 research team performed a systematic review and meta-analyses.

The team searched 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.

The research team's primary outcome was the incidence of adhesive small bowel obstruction in patients with a history of abdominal surgery.

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.

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

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

The team used a random effects model to account for heterogeneity between studies.

The researchers 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 team noted that the incidence of small bowel obstruction by any cause after abdominal surgery was 9%.

The incidence of adhesive small bowel obstruction was 2%.

The research team found 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.

The team observed that operative time was prolonged by 15 minutes in patients with previous surgery.

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 concludes, "This review provides detailed and systematically analyzed knowledge of the disease burden of adhesions."

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

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

BMJ 2013;347:f5588
14 July 2014

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

 26 January 2015

Advanced search
 26 January 2015 
Breath analysis for IBD
 26 January 2015 
Fecal microbiota transplantation
 26 January 2015 
Antidepressants and GERD
 23 January 2015 
Liver transplant outcomes
 23 January 2015 
Breath analysis in IBD
 23 January 2015 
Fecal microbiota transplantation
 22 January 2015 
NASH and lipid improvements
 22 January 2015 
NAFLD and NASH with psoriasis
 22 January 2015 
Predicting outcomes in HCV-related advanced liver disease
 21 January 2015 
Colon capsule versus CT colonography
 21 January 2015 
Barrett's esophagus screening in the community
 21 January 2015 
Portal vein obstruction
 20 January 2015 
Modulating mucosal damage in Crohn's
 20 January 2015 
Food intolerance
 20 January 2015 
Novel techniques for Barrett's screening
 19 January 2015 
Treatment of fecal incontinence
 19 January 2015 
Hepatic cyst infection
 19 January 2015 
Risk of IBS among relatives
 16 January 2015 
Fecal incontinence
 16 January 2015 
Colorectal cancer screening uptake
 16 January 2015 
NAFLD and NASH in patients with psoriasis
 15 January 2015 
Coffee intake and liver disease
 15 January 2015 
NAFLD in primary care practice
 15 January 2015 
Management of univestigated dyspepsia
 14 January 2015 
Missed colorectal cancers after colonoscopy with polypectomy
 14 January 2015 
Inflixmab response in Crohn's
 14 January 2015 
Statins and liver injury in chronic liver disease
 13 January 2015 
Cytomegalovirus in IBD
 13 January 2015 
Helicobacter-negative gastritis
 13 January 2015 
Hep B vaccine in IBD
 12 January 2015 
Survival in Hep B virus-related hepatocellular carcinoma
 12 January 2015 
Relapse of Crohn's disease after surgery
 12 January 2015 
Late liver metastases of colorectal cancer
 09 January 2015 
Fecal microbiota transplantation for refractory Crohn's
 09 January 2015 
Hypercoagulability after liver resection
 09 January 2015 
Naps and gastroesophageal reflux vs nocturnal sleep
 08 January 2015 
Post-infectious functional dyspepsia
 08 January 2015 
Diagnosis of liver iron overload
 08 January 2015 
Digestive tract damage in Crohn's disease
 07 January 2015 
Early-onset colorectal cancer
 07 January 2015 
SSRIs for noncardiac chest pain
 07 January 2015 
SSRIs and upper GI bleeds
 06 January 2015 
Detection of inflammation in Crohn's
 06 January 2015 
Leptin and early-onset extreme obesity
 06 January 2015 
Goals of IBD treatment
 19 December 2014 
Thiopurine treatment and colectomy in ulcerative colitis
 19 December 2014 
Idiopathic inflammatory demyelinating disease in IBD
 19 December 2014 
Colorectal cancer risk for first-degree relatives
 18 December 2014 
Vitamin D and sustained virologic response in HCV
 18 December 2014 
Factor for treatment in IBS
 18 December 2014 
Assessment of Crohn's disease activity
 17 December 2014 
Remission from hepatic encephalopathy with rifaximin
 17 December 2014 
Colonic adenoma recurrence after endoscopic resection
 17 December 2014 
Non-invasive measures of fatty liver
 16 December 2014 
Diagnostic tool for dysplasia in Barrett's
 16 December 2014 
Screening esophagus during routine US
 16 December 2014 
Therapeutic targets in IBD
 15 December 2014 
Food allergy and food intolerances
 15 December 2014 
Esophageal adenocarcinoma and Barrett's
 15 December 2014 
Outcomes of mildly abnormal liver function tests

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us