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Adhesion-related readmissions after open and laparoscopic surgery: A retrospective cohort study (SCAR update)

The Lancet Jan 10, 2020

Krielen P, Stommel MWJ, Pargmae P, et al. - Since adhesions are the most common driver of long-term morbidity after abdominal surgery, researchers evaluated the impact of laparoscopy on adhesion-related readmissions in a population-based cohort. The sample consisted of individuals of any age who had abdominal or pelvic surgery done using laparoscopic or open approaches between June 1, 2009, and June 30, 2011. For this investigation, they used validated population data from the Scottish National Health Service. Seventy-two thousand two hundred seventy individuals had an index abdominal or pelvic surgery, 21,519 of whom had laparoscopic index surgery and 50,751 had open surgery. Findings suggested an independent association of procedure type, malignancy, gender, and age with risk of adhesion-related readmissions. The incidence of adhesion-related readmissions is minimized by laparoscopic surgery. The overall readmission burden associated with adhesions, however, remains high. With further rises anticipated in the use of laparoscopic surgery in the future, the impact can increase at the population level. Further steps are needed to reduce the incidence of postoperative complications related to adhesion.
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