Investigating the Incidence and Management of Postoperative Adhesions in Abdominal Surgery
DOI:
https://doi.org/10.63682/jns.v13i1.9065Keywords:
Postoperative adhesions, abdominal surgery, surgical outcomes, adhesion prevention, laparoscopic adhesiolysisAbstract
Background: To determine the incidence, risk factors, and management outcomes of postoperative adhesions in patients undergoing abdominal surgery.
Methods: This prospective observational study included 77 patients who underwent elective or emergency abdominal surgery between August 2023 and August 2024. Demographic data, surgical characteristics, and postoperative follow-up findings were recorded. Adhesions were diagnosed through clinical assessment, imaging, or reoperation findings and graded using the Zühlke classification. Management outcomes, including recurrence and postoperative complications, were analyzed.
Results: Postoperative adhesions were detected in 28 patients (36.4%). Open surgery was associated with a significantly higher adhesion rate compared to laparoscopic procedures (p = 0.018). Colorectal resections (p = 0.029), operative duration >180 minutes (p = 0.011), and intraoperative complications (p = 0.041) were significant predictors. Small bowel adhesions were most common (46.4%), and 39.3% were classified as severe (Zühlke grade 3–4). Half of the cases were managed conservatively, while half required surgical adhesiolysis, with laparoscopic adhesiolysis resulting in shorter hospital stays (p = 0.041). Adhesion recurrence occurred in 21.4% of surgically treated cases, with no mortality reported.
Conclusion: Postoperative adhesions remain a significant burden after abdominal surgery, particularly in open, prolonged, and complicated operations. Preventive measures and early detection in high-risk patients are essential, while laparoscopic adhesiolysis offers favorable recovery when surgical intervention is required..
Downloads
Metrics
References
Fatehi Hassanabad, A., et al., Prevention of post-operative adhesions: a comprehensive review of present and emerging strategies. 2021. 11(7): p. 1027.
Fatehi Hassanabad, A., et al., Post-operative adhesions: a comprehensive review of mechanisms. 2021. 9(8): p. 867.
Rani, R., et al., Using different surgical techniques and ideas to reduce post-operative adhesion formation: a systematic review and meta-analysis. 10(9): p. 3561.
Herrmann, A., et al., Adhesions after laparoscopic myomectomy: incidence, risk factors, complications, and prevention. 2020. 9(4): p. 190-197.
Scott, F.I., et al., Association between statin use at the time of intra-abdominal surgery and postoperative adhesion-related complications and small-bowel obstruction. 2021. 4(2): p. e2036315-e2036315.
Al-Husban, N., et al., Surgical adhesions among women undergoing laparoscopic gynecological surgery with or without adhesiolysis–prevalence, severity, and implications: retrospective cohort study at a University Hospital. 2020. 14: p. 2633494120906010.
Wang, Y., et al., Establishments and evaluations of post‐operative adhesion animal models. 2023. 6(4): p. 2200297.
Tazeoğlu, D., et al., Can minimally invasive surgical techniques reduce the incidence of postoperative adhesions? 2022. 94(5): p. 23-29.
De Wilde, R.L., et al., The future of adhesion prophylaxis trials in abdominal surgery: an expert global consensus. 2022. 11(6): p. 1476.
Wu, F., et al., Application of traditional Chinese medicines in postoperative abdominal adhesion. 2020. 2020(1): p. 8073467.
Tian, W., et al., Risk factors and outcomes for postoperative ileus after small intestinal fistula excision in patients with diffuse extensive abdominal adhesions. 2021. 8: p. 632241.
Medvecz, A.J., et al., Impact of operative management on recurrence of adhesive small bowel obstruction: a longitudinal analysis of a statewide database. 2020. 230(4): p. 544-551. e1.
Sakari, T., M. Christersson, and U.J.B.s. Karlbom, Mechanisms of adhesive small bowel obstruction and outcome of surgery; a population-based study. 2020. 20(1): p. 62.
Sun, M., M. Xu, and J.J.H. Sun, Risk factor analysis of postoperative complications in patients undergoing emergency abdominal surgery. 2023. 9(3).
Tong, J.W.V., et al., Adhesive small bowel obstruction–an update. 2020. 7(1): p. e587.
Ghobrial, S., J. Ott, and J.P.J.J.o.C.M. Parry, An overview of postoperative intraabdominal adhesions and their role on female infertility: a narrative review. 2023. 12(6): p. 2263.
Gudiev, C., S. Minaev, and V.J.N.c.o.I. Vasiliev, Method of prevention of post-operative peritoneal adhesions. 2023. 10(1): p. 33.
Krämer, B., et al., Peritoneal adhesions and their prevention-current trends. 2021. 38: p. 221-233.
de Araújo Martins-Romeo, D. and A.R.J.R. Domínguez, Complications after abdominal surgery. 2023. 65: p. S99-S108.
Krielen, P., et al., Adhesion‐related readmissions after open and laparoscopic colorectal surgery in 16 524 patients. 2022. 24(4): p. 520-529.
van den Beukel, B., et al., Analgesia in patients with adhesion-related chronic abdominal and pelvic pain after surgery: a systematic review. 2022. 122(5): p. 303-311..
.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
