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World Journal of Surgery
Published in: World Journal of Surgery 7/2014

01-07-2014

Surgical Treatment and Perioperative Management of Idiopathic Abdominal Cocoon: Single-Center Review of 65 Cases

Authors: Ning Li, Weiming Zhu, Yi Li, Jianfeng Gong, Lili Gu, Min Li, Lei Cao, Jieshou Li

Published in: World Journal of Surgery | Issue 7/2014

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Abstract

Background

The abdominal cocoon (AC) is a condition in which a variable length of healthy small bowel is enveloped in a fibrocollagenous membrane, giving the appearance of a cocoon. Early experiences with treatment were associated with high mortality and morbidity rates and a low preoperative diagnostic rate, leading to underestimation of the treatment benefit of surgery.

Methods

We retrospectively reviewed the medical records of 65 patients who were diagnosed as having AC from 2001 to 2011. The clinical data, surgical intervention, and perioperative management were carefully reviewed.

Results

The 65 patients (57 male, 8 female) had a median age of 39 years (range 14–79 years). Patients who received preoperative nutritional support had higher rate of grade 0 complications (p = 0.012) and a lower rate of grade II complications (p = 0.012) than those without nutritional support. Intestinal stenting during surgical intervention also decreased both grade I (p = 0.012) and grade II (p = 0.007) complications. Patients who received preoperative nutritional support and underwent intestinal stenting had a lower rate of postoperative complications (p < 0.05). In addition, patients with preoperative nutritional support were more satisfied postoperatively (p = 0.018) than those without nutritional support. This was also observed in patients with intestinal stenting versus those without it (p = 0.027).

Conclusions

Our single-center study with a large number of patients provided evidence regarding the epidemiology of AC. Preoperative nutritional support and intestinal stenting significantly reduced postoperative complications and, more importantly, increased postoperative satisfaction.
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Metadata
Title
Surgical Treatment and Perioperative Management of Idiopathic Abdominal Cocoon: Single-Center Review of 65 Cases
Authors
Ning Li
Weiming Zhu
Yi Li
Jianfeng Gong
Lili Gu
Min Li
Lei Cao
Jieshou Li
Publication date
01-07-2014
Publisher
Springer US
Published in
World Journal of Surgery / Issue 7/2014
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-014-2458-6

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