Laparoscopic adhesiolysis for chronic abdominal pain is controversial. It is not evidence based.
In this study, researchers from the Netherlands assessed whether laparoscopic adhesiolysis led to pain relief and improved quality of life in patients with adhesions and chronic abdominal pain.
The patients in the study had diagnostic laparoscopy for chronic abdominal pain attributed to adhesions. Any other causes for their pain had been excluded.
|Both groups reported substantial pain relief.|
If adhesions were confirmed during diagnostic laparoscopy, the team then randomly assigned patients to either laparoscopic adhesiolysis or no treatment.
There were 116 patients enrolled for diagnostic laparoscopy, of these 100 were randomly allocated to either laparoscopic adhesiolysis (n = 52) or no treatment (n = 48).
Treatment allocation was concealed from patients, and assessors were also unaware of patients' treatment and outcome.
The team assessed the patients pain for 1 year by using a visual analogue score (VAS), pain change score, use of analgesics, and quality of life score.
Analysis was by intention to treat.
The research team found that both groups reported substantial pain relief and a significantly improved quality of life. However, the team determined no difference between the groups.
Dr Swank's team concluded, "Although laparoscopic adhesiolysis relieves chronic abdominal pain, it is not more beneficial than diagnostic laparoscopy alone".
"Therefore, laparoscopic adhesiolysis cannot be recommended as a treatment for adhesions in patients with chronic abdominal pain".