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Complications of adhesion-related disorder

Abstract:

Introduction: Abdominal adhesions are the main complication resulting from abdominal surgery. It can cause further complications such as bowel obstruction, chronic pelvic pain and infertility. Therefore, the purpose of this study is to determine the most frequent complications of abdominal adhesions in our population as well as its associated factors. Materials and methods: A descriptive retrospective study with 190 patients with adhesion disorder that were hospitalized in the Surgery Service of the Luis Vernaza Hospital of Guayaquil, Ecuador, was performed. A logistic regression model was executed in order to estimate the risk of developing complications due to adhesion disorder adjusted by: sex, age, previous surgery, prior surgical method, adhesion syndrome classification, surgical time and type of incision. P value was considered significant when it was lower than 0.05. Results: 45% (n=87) of the patients in the hospital had complications due to adhesion disorder. The most frequent complication was bowel obstruction (33.2%) followed by ischemia (12.1%), with a similar prevalence in both sexes. The age group with the greatest number of complications was the one with patients under 30 years old with a 36.7% (χ2 =6.885 (p=0.032)), whilst gastrointestinal surgery had the greatest prevalence of complications with 57.3% (χ2=8.994, p=0.029). On the other hand, surgery over 4 hours long resulted into a greater number of complications with 80% (χ2 =11.106, p=0.004) as well as open surgery during this second intervention 59.6% (χ2 =41.854, p<0.001). According to the multivariate factors analysis, the ones that showed the greater influence for complications development were grade II adhesion disorder (OR=5.71; IC95%: 2.07-15.68), grade III (OR=4.08; IC95%: 8.64-136.78) and IV (OR=31.08; IC95%: 7.84-123,21); as well as open surgery (OR=7.32; IC95%: 1.83-29.30). Conclusions: Complications caused by abdominal adhesions are frequent in our population, with a special prevalence of bowel obstruction. It is necessary to consider the laparoscopic approach over open surgery when it is possible, as well as minimizing surgery length in order to decrease the prevalence of abdominal adhesions and their complications in our patients.