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Rate of Adhesion-Related Complications HighThe rate of complications associated with adhesions following abdominal and pelvic surgery is high, according to a retrospective cohort study published in The Lancet (1999;353:1456-1457). The leader of the study, Dr. Harold Ellis, described the readmissions for adhesion-related complications as a .substantial burden" having "important consequences to patients, surgeons and the health system." Dr. Ellis is a professor in the Division of Anatomy, Cell and Human Biology at The Guy's, King's and St. Thomas' School of Biomedical Sciences, London. The team used data from the Scottish National Health Service medical record database to identify patients undergoing open abdominal or pelvic surgery in 1986. Altogether, 21,374 readmissions for adhesion-related complications were recorded during 10-year follow-up. Of the readmissions, 1,209 (5.7%) were directly related to adhesions. Surgery was performed to address the adhesions in 768 readmissions (3.6%). However, the researchers suggest that because of the design of their study, these figures most likely underestimate the actual number of readmissions for adhesions. According to Dr. Ellis and his team, .overall, 34.6 percent of the 29,790 patients who underwent open abdominal or pelvic surgery in 1986 were readmitted a mean of 2.1 times over 10 years for a disorder directly or possibly related to adhesions, or for abdominal or pelvic surgery that could be potentially complicated by adhesions." The study authors stressed the importance of identifying high-risk procedures associated with adhesion complications and the need to develop effective prevention strategies. in a commentary following the study, Dr. Lena Holmdahl, associate professor of medicine at Gothenburg University, in Sweden, referred to the group's work as a "cornerstone in delineating the problem" of adhesion-related complications. "Perhaps this study will stimulate industry, administrators and surgeons alike to acknowledge the size of the problem posed by adhesions and to act,"Dr. Holmdahl wrote. |
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