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Laparoscopic adhesiolysis for chronic abdominal pain: an objective assessment
A J Bremers1, J Ringers, A Vijn
1Department of Surgery, Leiden University Medical Center, The Netherlands. bremersklaver@noknok.nl
Background And Purpose:
Postoperative adhesions frequently occur and can account for various symptoms, including chronic abdominal pain. Conventional adhesiolysis by laparotomy results in an unacceptably high rate of recurrence. A minimally invasive procedure (laparoscopic adhesiolysis) might improve the outcome by inflicting less surgical trauma, but well-documented reports focused on laparoscopic adhesiolysis for chronic abdominal pain are lacking.
Patients And Methods:
Twelve consecutive patients with chronic abdominal pain caused by adhesions who were treated by laparoscopic adhesiolysis were assessed preoperatively and during a 1-year follow-up period applying validated scoring systems: McGill and SLC-90 tests to evaluate personalities and MOS SF-36 and GIQLI questionnaires for the quality of life assessments.
Results:
No psychological influences were identified. Only two patients experienced a lasting improvement in quality of life, and five patients had more or less stable complaints. Five patients required laparotomy within a year after laparoscopic adhesiolysis.
Conclusions:
Laparoscopic adhesiolysis has yet not passed the stage of clinical trial and requires objective evaluation, including detailed information on recurrence and de novo adhesions in correlation with clinical outcome.