Long-term outcomes and quality of life after laparoscopic adhesiolysis for chronic abdominal pain

被引:10
作者
Dunker, MS
Bemelman, WA
Vijn, A
Jansen, FW
Peters, AAW
Janss, RAJ
Gouma, DJ
机构
[1] Acad Med Ctr, Dept Surg, NL-1105 AZ Amsterdam, Netherlands
[2] Leiden Univ, Ctr Med, Dept Surg, Amsterdam, Netherlands
[3] Leiden Univ, Ctr Med, Dept Surg, Amsterdam, Netherlands
[4] Leiden Univ, Ctr Med, Dept Anaesthesiol, Amsterdam, Netherlands
[5] Leiden Univ, Ctr Med, Dept Gynaecol, Amsterdam, Netherlands
来源
JOURNAL OF THE AMERICAN ASSOCIATION OF GYNECOLOGIC LAPAROSCOPISTS | 2004年 / 11卷 / 01期
关键词
D O I
10.1016/S1074-3804(05)60007-2
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Study Objective. To evaluate clinical outcome in terms of pain and quality of life after laparoscopic adhesiolysis. Design. Prospective observational study (Canadian Task Force II-3). Setting. University-affiliated medical center. Patients. Twenty-three patients (22 women). Intervention. Laparoscopic adhesiolysis for chronic abdominal pain. Measurements and Main Results. Pain was assessed by validated McGill score. Patients with an intraindividual decrease in pain score of 5 points or more were considered successes. Quality of life was assessed by the SF-36 and gastrointestinal quality of life index. Patients were evaluated before and at intervals until 2 years after adhesiolysis. The mean pain score before adhesiolysis was 30.5 (range: 17-40). At 2 years of follow-up, 10 (45%) of 22 patients (95% CI 0.244-0.678) were considered successes. They reported significant improvement in quality of life on scales physical, role physical, and social function, and fewer gastrointestinal symptoms, Twelve women (55%) had a complete relapse, and most were not motivated to visit the pain clinic after 6 months. Conclusion. Laparoscopic adhesiolysis for chronic abdominal pain was successful in only 45% of patients.
引用
收藏
页码:36 / 41
页数:6
相关论文
共 22 条
[1]   Incidence of small-bowel obstruction and adhesiolysis after open colorectal and general surgery [J].
Beck, DE ;
Opelka, FG ;
Bailey, HR ;
Rauh, SM ;
Pashos, CL .
DISEASES OF THE COLON & RECTUM, 1999, 42 (02) :241-248
[2]   SURGERY AS PLACEBO - A QUANTITATIVE STUDY OF BAS [J].
BEECHER, HK .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1961, 176 (13) :1102-&
[3]   Laparoscopy versus laparotomy: An evaluation of adhesion formation after pelvic and paraaortic lymphadenectomy in a porcine model [J].
Chen, MD ;
Teigen, GA ;
Reynolds, HT ;
Johnson, PR ;
Fowler, JM .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1998, 178 (03) :499-503
[4]  
Cook ThomasD., 1979, Quasi-experimentation: Design analysis issues for field settings
[5]  
DIAMOND MP, 1991, FERTIL STERIL, V55, P700
[6]  
DIAMOND MP, 1994, FERTIL STERIL, V62, P984
[7]  
ELLKIS H, 1999, LANCET, V353, P147
[8]  
Ettema J.H.M., 1981, NEDERLANDS TIJDSCHRI, V36, P77
[9]   GASTROINTESTINAL QUALITY-OF-LIFE INDEX - DEVELOPMENT, VALIDATION AND APPLICATION OF A NEW INSTRUMENT [J].
EYPASCH, E ;
WILLIAMS, JI ;
WOODDAUPHINEE, S ;
URE, BM ;
SCHMULLING, C ;
NEUGEBAUER, E ;
TROIDL, H .
BRITISH JOURNAL OF SURGERY, 1995, 82 (02) :216-222
[10]   POSTOPERATIVE ADHESIVE PERITONEAL DISEASE - LAPAROSCOPIC TREATMENT [J].
FRANCOIS, Y ;
MOURET, P ;
TOMAOGLU, K ;
VIGNAL, J .
SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES, 1994, 8 (07) :781-783