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Laparoscopic ileal pouch-anal anastomosis reduces abdominal and pelvic adhesions.
- Source :
-
Surgical endoscopy [Surg Endosc] 2009 Jan; Vol. 23 (1), pp. 174-7. Date of Electronic Publication: 2008 Oct 15. - Publication Year :
- 2009
-
Abstract
- 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).<br />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.<br />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.<br />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.
- Subjects :
- Adnexal Diseases pathology
Adult
Aged
Cohort Studies
Female
Humans
Male
Middle Aged
Peritoneal Diseases pathology
Retrospective Studies
Tissue Adhesions epidemiology
Tissue Adhesions pathology
Young Adult
Adnexal Diseases epidemiology
Colitis, Ulcerative surgery
Colonic Pouches
Laparoscopy
Peritoneal Diseases epidemiology
Proctocolectomy, Restorative
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2218
- Volume :
- 23
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Surgical endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 18855064
- Full Text :
- https://doi.org/10.1007/s00464-008-0139-y