Document Detail


Long-term outcome, adhesions, and quality of life after laparoscopic and open surgical therapies for acute abdomen: follow-up of a prospective trial.
MedLine Citation:
PMID:  15529189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The objective of this study was to determine the long-term outcome of laparoscopic and open therapies for acute abdomen, and to assess the patients postoperative quality of life, with special attention to adhesions. METHODS: A follow-up study was conducted from June through December 2001 of a case-control trial of laparoscopic and open surgical treatment in patients with acute abdomen. Mean (median) duration of follow-up was 35.9 months (32.5) for the laparoscopic group (L) and 40.7 months (38.5) for the open group (O). A total of 284 (92%) of the original 310 study patients (108 L and 202 O) were contacted. Twenty-eight (9%) were confirmed to be dead. From the remaining 256 patients (131 men and 125 women, mean age [+/- SD] 38.9 +/- 19.9 years), we enrolled 153(67 L and 91 O) in the follow-up. The main outcome measures were frequency of relapse requiring treatment, frequency of reoperations, incidence of adhesion ileus and incisional hernia, distant morbidity and mortality, satisfaction with therapy, and Gastrointestinal Quality of Life Index (GQLI) scores. RESULTS: The morbidity and mortality rates, readmission rates, incisional hernia rates, and scores for long-term quality of life were the same in both groups. The reoperation rate was significantly higher among L patients, but there were significantly fewer episodes of adhesion ileus in this group. Patient satisfaction was 85% in the L group and 73% in the O group (p = NS). CONCLUSIONS: The laparoscopic treatment of patients with acute abdomen offers an outcome comparable to that achieved with the open approach. There were fewer episodes of adhesion ileus in laparoscopic patients. Consequently, the operative treatment of acute abdomen patients by laparoscopy can be recommended.
Authors:
W D Majewski
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Publication Detail:
Type:  Journal Article     Date:  2004-11-11
Journal Detail:
Title:  Surgical endoscopy     Volume:  19     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-03-17     Completed Date:  2006-04-26     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  81-90     Citation Subset:  IM    
Affiliation:
Department of General and Transplantation Surgery and Faculty of Nursing, Pomeranian Medical University, Szczecin, Poland. wdmajewski@poczta.wp.pl
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MeSH Terms
Descriptor/Qualifier:
Abdomen, Acute / mortality,  surgery*
Adolescent
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Laparoscopy / adverse effects*
Male
Middle Aged
Prospective Studies
Quality of Life*
Survival Rate
Time Factors
Tissue Adhesions / epidemiology,  etiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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