BACKGROUND: Postoperative adhesions are an expected outcome for the majority of open abdominal operations, occurring in more than 90% of cases. Adhesions are responsible for more than 75% of small bowel obstruction cases. This study aimed to evaluate adhesions to the anterior abdominal wall and adnexal organs after laparoscopic ileal-pouch anal anastomosis (IPAA). METHODS: Patients who underwent laparoscopic IPAA for ulcerative colitis had laparoscopic evaluation of adhesions at loop ileostomy closure for assessment of adhesions to the anterior abdominal wall and for adhesions to the adnexae in the case of women. Adhesions to the adnexae were quantified using the American Fertility Society adhesion score. Data were maintained prospectively. RESULTS: In this study, 34 patients (21 women) ranging in age from 19 to 78 years (median, 36 years) underwent laparoscopic IPAA. With regard to anterior abdominal wall adhesions, 23 patients (68%) had no adhesions to the anterior abdominal wall, and the remaining 11 patients had few adhesions (filmy, avascular). No patients had dense adhesions to the abdominal wall. Of the 21 women, 15 (71%) had no adnexal adhesions, 5 had filmy adhesions enclosing less than one-third one adnexa, and 1 had filmy adhesions enclosing one-third to two-thirds of one adnexa. No patient had adhesions affecting both adnexae. CONCLUSIONS: Laparoscopic IPAA results in few adhesions to the anterior abdominal wall or to gynecologic organs. These adhesions were significantly fewer than previously reported for open operations with or without the use of a glycerol hyaluronate/carboxymethylcellulose bioresorbable (GHA/CMC) adhesion barrier.
BACKGROUND: Postoperative adhesions are an expected outcome for the majority of open abdominal operations, occurring in more than 90% of cases. Adhesions are responsible for more than 75% of small bowel obstruction cases. This study aimed to evaluate adhesions to the anterior abdominal wall and adnexal organs after laparoscopic ileal-pouch anal anastomosis (IPAA). METHODS:Patients who underwent laparoscopic IPAA for ulcerative colitis had laparoscopic evaluation of adhesions at loop ileostomy closure for assessment of adhesions to the anterior abdominal wall and for adhesions to the adnexae in the case of women. Adhesions to the adnexae were quantified using the American Fertility Society adhesion score. Data were maintained prospectively. RESULTS: In this study, 34 patients (21 women) ranging in age from 19 to 78 years (median, 36 years) underwent laparoscopic IPAA. With regard to anterior abdominal wall adhesions, 23 patients (68%) had no adhesions to the anterior abdominal wall, and the remaining 11 patients had few adhesions (filmy, avascular). No patients had dense adhesions to the abdominal wall. Of the 21 women, 15 (71%) had no adnexal adhesions, 5 had filmy adhesions enclosing less than one-third one adnexa, and 1 had filmy adhesions enclosing one-third to two-thirds of one adnexa. No patient had adhesions affecting both adnexae. CONCLUSIONS: Laparoscopic IPAA results in few adhesions to the anterior abdominal wall or to gynecologic organs. These adhesions were significantly fewer than previously reported for open operations with or without the use of a glycerol hyaluronate/carboxymethylcellulose bioresorbable (GHA/CMC) adhesion barrier.
Authors: Marco Braga; Andrea Vignali; Walter Zuliani; Giovanni Radaelli; Luca Gianotti; Carla Martani; Gilles Toussoun; Valerio Di Carlo Journal: Dis Colon Rectum Date: 2002-08 Impact factor: 4.585
Authors: Victor W Fazio; Zane Cohen; James W Fleshman; Harry van Goor; Joel J Bauer; Bruce G Wolff; Marvin Corman; Robert W Beart; Steven D Wexner; James M Becker; John R T Monson; Howard S Kaufman; David E Beck; H Randolph Bailey; Kirk A Ludwig; Michael J Stamos; Ara Darzi; Ronald Bleday; Richard Dorazio; Robert D Madoff; Lee E Smith; Susan Gearhart; Keith Lillemoe; Jonas Göhl Journal: Dis Colon Rectum Date: 2006-01 Impact factor: 4.585
Authors: Zane Cohen; Anthony J Senagore; Merril T Dayton; Mark J Koruda; David E Beck; Bruce G Wolff; Phillip R Fleshner; Richard C Thirlby; Kirk A Ludwig; Sergio W Larach; Eric G Weiss; Joel J Bauer; Lena Holmdahl Journal: Dis Colon Rectum Date: 2005-06 Impact factor: 4.585
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