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 20 April 2018

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News

High workload due to postoperative adhesions after colorectal surgery

There is a high relative risk of adhesion-related problems after open lower abdominal surgery, and improved adhesion prevention strategies are warranted, claims a team from the United Kingdom

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The researchers investigated the incidence of postoperative adhesions after colorectal surgery, and reported their findings in the June issue of Diseases of the Colon and Rectum. A cohort of 12,584 patients who underwent open lower abdominal surgery in 1986, was identified from the Scottish National Health Service Medical Record Linkage Database.

The team analyzed readmissions for potential adhesion-related disease, in the 10 years following surgery.

32.6% of all patients were readmitted (mean, 2.2 times) in the subsequent 10 years, for a potential adhesion-related problem.

25.4% of readmissions were in the first postoperative year. However, they continued steadily throughout the study period.

After open lower abdominal surgery, 7.3% of readmissions were directly related to adhesions. This varied according to operation site: colon (7.1%), rectum (8.8%), and small intestine (7.6%).

Colonic and rectal surgery had highest risk of adhesions.
Diseases of the Colon and Rectum

The readmission rate was assessed to provide an indicator of relative risk of adhesion-related problems after initial surgery.

The overall average rate of readmissions was 70.4 per 100 initial operations, with 5.1 directly related to adhesions.

This rose to 116.4 and 116.5, respectively, after colonic or rectal surgery - with 8.2 and 10.3 directly related to adhesions.

Investigator Michael C. Parker, of the Darent Valley Hospital, Dartford, England, said on behalf of fellow authors, "There is a high relative risk of adhesion-related problems after open lower abdominal surgery, and a correspondingly high workload associated with these readmissions.

"This is influenced by the initial site of surgery. Both colon and rectum have the greatest impact on workload and the highest relative risk of directly adhesion-related problems."

"This study provides sound justification for improved adhesion prevention strategies," he concluded.

Dis Colon Rec 2001; 44: 822-30
12 June 2001

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