Burden of adhesions in abdominal and pelvic surgery: systematic review and met-analysis скачать в хорошем качестве

Burden of adhesions in abdominal and pelvic surgery: systematic review and met-analysis

Read the full research online:http://www.bmj.com/content/347/bmj.f5588 Postoperative adhesion formation is the most common complication of abdominal or pelvic surgery, which is frequently performed by general, vascular, and gynaecological surgeons and urologists. Unlike other postoperative complications, such as wound infection or anastomotic leakage, the consequences of adhesion formation comprise a lifelong risk for various clinical entities. Patients with adhesion related complications are often treated by specialists other than the surgeon who did the first operation. The first surgeon therefore remains unaware of the complication, which might explain the gross underestimation of adhesion related complications among surgeons and gynaecologists. In this systematic review with meta-analyses, the authors from The Netherlands studied the incidence of the four most important complications of postoperative adhesion formation: small bowel obstruction, difficulties at repeated abdominal surgery, female infertility, and chronic pain. A more valid estimate of the disease burden of adhesions will increase the awareness of this complication, which can be used in counselling and clinical practice. The authors carried out a systematic review of the literature and a meta-analysis of the studies found they concluded that complications of postoperative adhesion formation are frequent, have a large negative effect on patients' health, and increase workload in clinical practice. However they caution that there was large heterogeneity in the data that they found, and so quantitative effects should be interpreted with that in mind.