Reoperation on the abdomen encased in adhesions

Eric A. Harris, Ann W. Kelly, Barbara A. Pockaj, Jacques Heppell, Joseph G. Hentz, Keith A. Kelly, Philip Huber, John Aucar, John Thompson, Ron Squires, Clayton H. Shatney

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Purpose: To determine outcome after lysis of intestinal adhesions, relief of obstruction, closure of fistulas and drainage of abscesses in patients with an abdominal cavity obliterated by chronic postoperative adhesions. Methods: Among 40 patients with an abdomen encased in dense adhesions after a mean of 5 previous operations, 31 patients also had intestinal obstruction, 25 enteric fistulas and 20 abdominal abscesses. Reoperation was done and outcome assessed from the medical records and by a mailed questionnaire. Results: Only 1 postoperative death occurred, but 24 early complications appeared. At hospital discharge, obstruction, fistula and abscess were completely resolved in all but 3 patients (P <0.001). Only 2 of 16 patients on parenteral nutrition before operation (TPN) still required it (P = 0.004). At late follow-up (mean, 4.6 years) the patients' quality of life (mean score ± SD, 8.6 ± 2.1) was similar to that of a healthy control population (9.2 ± 1.2, P = 0.17). Conclusions: Reoperation on the abdomen encased in adhesions restores most patients to good health and an excellent long-term quality of life.

Original languageEnglish (US)
Pages (from-to)499-504
Number of pages6
JournalAmerican journal of surgery
Volume184
Issue number6
DOIs
StatePublished - Dec 1 2002

Keywords

  • Abdominal abscesses
  • Intestinal adhesions
  • Intestinal fistulas
  • Intestinal obstruction
  • Postoperative quality of life

ASJC Scopus subject areas

  • Surgery

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    Harris, E. A., Kelly, A. W., Pockaj, B. A., Heppell, J., Hentz, J. G., Kelly, K. A., Huber, P., Aucar, J., Thompson, J., Squires, R., & Shatney, C. H. (2002). Reoperation on the abdomen encased in adhesions. American journal of surgery, 184(6), 499-504. https://doi.org/10.1016/S0002-9610(02)01067-X