A prospective study of morbidity during adhesiolysis

Background: One of the most common causes of morbidity caused during adhesiolysis is inadvertent enterotomy. It is important to have awareness about the adhesiolysis-related morbidity to properly inform the patients of the risks before surgery, for surgeons to take these risks into consideration while making operative decisions, and to get better at the diagnosis of post-operative complications. Patients and Methods: We did a prospective observational study on 55 patients who underwent laparotomy for adhesiolysis at the J.L.N. Medical College, Ajmer. Study period was 24 months, from January 2015 to January 2017, including a follow-up period of 6 months. Our primary aim was to do a detailed assessment and analysis of adhesiolysis and to assess the post-operative complications related to adhesiolysis. Results: The incidence of full thickness bowel defects was 9 (16.36%). Bowel resection and anastomosis were required in five operations (55.56%). The severity of adhesions and adhesiolysis time was more with patients with two or more previous laparotomies, mean 132 ± 40.27 min. Re-admission rates were also much higher in patients who had enterotomy. Conclusion: This study has demonstrated the substantial clinical burden of adhesiolysis, particularly when a bowel defect occurs.