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Laparoscopic Adhesiolysis in Chronic Abdominal Pain: 15-Year Follow-up Study
Paavo Paajanen1, Anne Fagerström2, Hannu Paajanen2,3
1School of Medicine, Faculty of Health Sciences, University of Eastern Finland.
Background/Goal:
Intra-abdominal adhesions are probably underdiagnosed cause for chronic abdominal pain. Our aim was to evaluate late (>10 y) effect of laparoscopic adhesiolysis on chronic abdominal pain.
Study:
This was a nonrandomized follow-up study of 68 patients (9 males, 59 females) who suffered chronic abdominal pain. The index operation (laparoscopy and adhesiolysis; n=72 patients) was performed during 1997 to 2001. A quality-of-life questionnaire was asked after the mean follow-up time of 15 years. The hospital records of patients, reoperations for chronic abdominal pain, and full medical history were also reviewed.
Results:
Patients reported that adhesion-related pain was abolished or diminished in 90% during 15-year follow-up, but still 28 (41%) complained about some abdominal symptom. One third of the patients used pain-relieving medication or proton-pump inhibitors to relieve their symptoms. Furthermore, 46 (68%) patients had contacted medical service for reexamination of abdominal discomfort and 16 (24%) were reoperated because of some abdominal disease. When the patients with dense adhesions versus no or minimal adhesions were compared in the long term, no difference in the response of pain was noticed after 15 years of adhesiolysis.
Conclusions:
In carefully selected patients suffering from chronic abdominal pain, the positive effect of laparoscopic adhesiolysis stands beyond 15 years after the surgery. Although the patients reported relief of pain they still had various abdominal symptoms.
