A Randomized Clinical Trial on the Benefit of Adhesiolysis in Patients With Intraperitoneal Adhesions and Chronic Pelvic Pain

Peters, A. C. B.; Trimbos-Kemper, G.C.M.; Admiraal, C.; Trimbos, J. B.; Hermans, J.

doi:10.1097/00006254-199208000-00016

Cited by 36 publications

(44 citation statements)

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“…[22] Long-term benefits from this surgical approach are also unconvincing, with many patients reexperiencing abdominal pain only one year after surgery, often due to worsening or de novo formation of additional adhesions. [23][24][25] In the present case, we reported the use of an innovative soft tissue therapy to treat a female with a one-year history of abdominal pain caused by two small-bowel narrowed areas secondary to surgically-induced adhesions. After 20 hours of intensive, individualized manual physical therapy performed over four consecutive days with a focus on deforming and detaching adhesive crosslinks, this patient experienced near complete resolution of her chronic pain that coincided with radiographic resolution of both of the previously identified small intestine strictures.…”

Section: Discussionmentioning

confidence: 94%

Manual physical therapy clears adhesive bowel obstruction and strictures in a patient with Crohn’s disease

Weinstock¹,

Pratt²,

Wurn³

et al. 2018

IJCR

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A woman with Crohn's disease with prior resection presented with a one-year history of persistent abdominal pain. The small bowel follow-through radiograph demonstrated the presence of two strictures in the small intestine due to adhesive scarring.Opting for conservative management, the patient underwent a specialized manual physical therapy regimen. Following treatment, the patient experienced significant decrease of abdominal pain and improved biomechanical function. Radiologic imaging revealed complete resolution of both strictures. Manual physical therapy may be a viable non-operative option to manage small bowel strictures or obstruction.

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Section: Discussionmentioning

confidence: 94%

Manual physical therapy clears adhesive bowel obstruction and strictures in a patient with Crohn’s disease

Weinstock¹,

Pratt²,

Wurn³

et al. 2018

IJCR

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“…Adhesiolysis of deep/dense adhesions has been shown to be of proven benefit. 15,16 In a study by Eltabbakh et al, 17 laparoscopic management of benign ovarian cysts (mucinous/serous cystadenoma, dermoid cysts, endometriosis, etc.) with cystectomy or oophorectomy is a feasible and safe option for women with a short hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopy in Gynecology: Experience from a Rural Hospital

Bhutani¹,

Kaur²,

Sharma³

2016

WJOLS

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“…While retrospective and prospective studies have shown improvement in 50-90% of cases after laparoscopic adhesiolysis [63][64][65][66][67][68], only very few studies fulfilled the conditions of a controlled or even prospective randomised design. In randomised studies, the evidence is more ambiguous, and it is unclear if adhesiolysis is a successful treatment option in the majority of women [41,69]. As there is a known high rate of reformation of adhesions following surgery (mean reformation rate of 85%) regardless of the method of adhesiolysis [3], and as chronic pain may have multifactorial causes, e.g.…”

Section: Chronic Pelvic Painmentioning

confidence: 99%

Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position

DeWilde

Trew

2007

Gynecol Surg

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Adhesions are the most frequent complication of abdominopelvic surgery, yet many surgeons are still not aware of the extent of the problem and its serious consequences. While adhesions may cause few or no detrimental effects to patients, in a considerable proportion of cases there are major short-and long-term consequences, including small-bowel obstruction, infertility and chronic pelvic pain. Adhesions complicate future surgery with important associated morbidity and expense-and a considerable risk of mortality. Despite advances in surgical techniques in recent years, the burden of adhesion-related complications has not changed. Adhesions should now be considered the most common complication of abdominopelvic surgery. Adhesiolysis remains the main treatment, despite the fact that adhesions reform in most patients. Developments in adhesion-reduction strategies and new agents now offer a realistic possibility of reducing the risk of adhesions forming and can improve the outcomes for patients and the associated onward burden. This consensus position represents the collective views of 35 gynaecologists with a recognised interest in adhesions. The position is presented in two parts. The first part reviews the published literature on the extent of the problem of adhesions, and the second part considers the opportunities to reduce their incidence. It also provides collective proposals on the actions that European gynaecologists should take to avoid causing adhesions. Importantly it also advises that it is now time to inform patients of the risks associated with adhesion-related complications during the consent process. With increasing evidence to support the efficacy of adhesion-reduction agents to complement good surgical practice, all surgeons should act now to reduce adhesions and fulfil their duty of care to patients.

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A Randomized Clinical Trial on the Benefit of Adhesiolysis in Patients With Intraperitoneal Adhesions and Chronic Pelvic Pain

Cited by 36 publications

References 0 publications

Manual physical therapy clears adhesive bowel obstruction and strictures in a patient with Crohn’s disease

Manual physical therapy clears adhesive bowel obstruction and strictures in a patient with Crohn’s disease

Laparoscopy in Gynecology: Experience from a Rural Hospital

Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position

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