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[Laparoscopic adhesiolysis - results following prospective surveillance]
C Schenk1, H Scheuerecker, F Glaser
1Abteilung für Chirurgie (Leitender Arzt: Priv.-Doz. Dr. F. Glaser), Filderklinik, Filderstadt. billroth3@aol.com
Introduction:
About 90 % of the patients have abdominal surgery develop adhesions afterward. Studies analyzing complications and follow-up even in emergency cases are rare.
Methods:
Intra- and postoperative findings and complications and follow-up were analyzed in a prospective trial between January 1994 and June 1998.
Results:
We performed laparoscopic procedures in 56 patients with complaints of obstructing adhesive bands or adhesions. Ninety-six percent of the patients have had abdominal surgery; 51.8 % were treated as emergency cases with acute pain, 48.2 % with chronic abdominal pain. Intraoperatively, 37.5 % of the patients showed single adhesive bands; 62.5 % showed adhesions. Mean operation time was 60 min, conversion rate: 5.4 %. Complications were recorded according to the "Cologne classification": class I: 78.6 %, class II: 8.9 %, class III: 1.8 %, class IV: 10.8 %, class V: 0 %. The postoperative hospital stay was 6 days on average.
Conclusion:
Our study suggests that laparoscopic adhesiolysis can be done safely in emergency cases and in patients with extensive adhesions as well.