Skip to main content
Top
Published in: Archives of Gynecology and Obstetrics 5/2011

01-05-2011 | General Gynecology

Patients’ awareness of postoperative adhesions: results from a multi-centre study and online survey

Authors: Bernhard Kraemer, Jennifer C. Birch, Judy V. Birch, Nina Petri, Umar Ahmad, Dilshad Marikar, Markus Wallwiener, Christian Wallwiener, Amanda Foran, Taufiek K. Rajab

Published in: Archives of Gynecology and Obstetrics | Issue 5/2011

Login to get access

Abstract

Purpose

To analyse and to compare how female patients are informed about adhesions and their related problems by surgeons preoperatively.

Methods

Over 8 weeks 105 patients (Germany) and 82 (UK) patients admitted for laparoscopic or open abdominopelvic surgery were interviewed preoperatively in a multi-centre study in Germany and the UK. 212 responses to an online survey were also analysed.

Results

Less than 50% of patients are made aware of adhesions. Even fewer patients were told about complications caused by adhesions. Lack of knowledge is cited by 46% of patients as a reason for health professionals not informing them about adhesions. 41% considered adhesions as not sufficiently important. Patients who had previously heard of adhesions were most commonly informed by physicians.

Conclusions

There is lack of information among patients and physicians about adhesions and their complications. Written information before surgery and computer-based applications may help raise patient’s awareness.
Literature
1.
go back to reference Menzies D, Ellis H (1990) Intestinal obstruction from adhesions—how big is the problem? Ann R Coll Surg Engl 72(1):60–63PubMed Menzies D, Ellis H (1990) Intestinal obstruction from adhesions—how big is the problem? Ann R Coll Surg Engl 72(1):60–63PubMed
2.
go back to reference Parker MC, Wilson MS, van Goor H, Moran BJ, Jeekel J, Duron JJ, Menzies D, Wexner SD, Ellis H (2007) Adhesions and colorectal surgery—call for action. Colorectal Dis 9(Suppl 2):66–72PubMedCrossRef Parker MC, Wilson MS, van Goor H, Moran BJ, Jeekel J, Duron JJ, Menzies D, Wexner SD, Ellis H (2007) Adhesions and colorectal surgery—call for action. Colorectal Dis 9(Suppl 2):66–72PubMedCrossRef
3.
go back to reference Stanciu D, Menzies D (2007) The magnitude of adhesion-related problems. Colorectal Dis 9(Suppl 2):35–38PubMedCrossRef Stanciu D, Menzies D (2007) The magnitude of adhesion-related problems. Colorectal Dis 9(Suppl 2):35–38PubMedCrossRef
4.
go back to reference Rajab TK, Wallwiener M, Talukdar S, Kraemer B (2009) Adhesion-related complications are common, but rarely discussed in preoperative consent: a multicenter study. World J Surg 33(4):748–750PubMedCrossRef Rajab TK, Wallwiener M, Talukdar S, Kraemer B (2009) Adhesion-related complications are common, but rarely discussed in preoperative consent: a multicenter study. World J Surg 33(4):748–750PubMedCrossRef
5.
go back to reference Ellis H (1997) The clinical significance of adhesions: focus on intestinal obstruction. Eur J Surg Suppl (577):5–9 Ellis H (1997) The clinical significance of adhesions: focus on intestinal obstruction. Eur J Surg Suppl (577):5–9
6.
go back to reference Stovall TG, Elder RF, Ling FW (1989) Predictors of pelvic adhesions. J Reprod Med 34(5):345–348PubMed Stovall TG, Elder RF, Ling FW (1989) Predictors of pelvic adhesions. J Reprod Med 34(5):345–348PubMed
7.
go back to reference Tulandi T, Collins JA, Burrows E, Jarrell JF, McInnes RA, Wrixon W, Simpson CW (1990) Treatment-dependent and treatment-independent pregnancy among women with periadnexal adhesions. Am J Obstet Gynecol 162(2):354–357PubMed Tulandi T, Collins JA, Burrows E, Jarrell JF, McInnes RA, Wrixon W, Simpson CW (1990) Treatment-dependent and treatment-independent pregnancy among women with periadnexal adhesions. Am J Obstet Gynecol 162(2):354–357PubMed
8.
go back to reference Marana R, Rizzi M, Muzii L, Catalano GF, Caruana P, Mancuso S (1995) Correlation between the American Fertility Society classifications of adnexal adhesions and distal tubal occlusion, salpingoscopy, and reproductive outcome in tubal surgery. Fertil Steril 64(5):924–929PubMed Marana R, Rizzi M, Muzii L, Catalano GF, Caruana P, Mancuso S (1995) Correlation between the American Fertility Society classifications of adnexal adhesions and distal tubal occlusion, salpingoscopy, and reproductive outcome in tubal surgery. Fertil Steril 64(5):924–929PubMed
9.
go back to reference van Goor H (2007) Consequences and complications of peritoneal adhesions. Colorectal Dis 9(Suppl 2):25–34PubMedCrossRef van Goor H (2007) Consequences and complications of peritoneal adhesions. Colorectal Dis 9(Suppl 2):25–34PubMedCrossRef
10.
go back to reference Van Der Krabben AA, Dijkstra FR, Nieuwenhuijzen M, Reijnen MM, Schaapveld M, Van Goor H (2000) Morbidity and mortality of inadvertent enterotomy during adhesiotomy. Br J Surg 87(4):467–471CrossRef Van Der Krabben AA, Dijkstra FR, Nieuwenhuijzen M, Reijnen MM, Schaapveld M, Van Goor H (2000) Morbidity and mortality of inadvertent enterotomy during adhesiotomy. Br J Surg 87(4):467–471CrossRef
11.
go back to reference Parker MC, Wilson MS, Menzies D, Sunderland G, Clark DN, Knight AD, Crowe AM (2005) The SCAR-3 study: 5-year adhesion-related readmission risk following lower abdominal surgical procedures. Colorectal Dis 7(6):551–558PubMedCrossRef Parker MC, Wilson MS, Menzies D, Sunderland G, Clark DN, Knight AD, Crowe AM (2005) The SCAR-3 study: 5-year adhesion-related readmission risk following lower abdominal surgical procedures. Colorectal Dis 7(6):551–558PubMedCrossRef
12.
go back to reference Ellis H, Moran BJ, Thompson JN, Parker MC, Wilson MS, Menzies D, McGuire A, Lower AM, Hawthorn RJ, O’Brien F, Buchan S, Crowe AM (1999) Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study. Lancet 353(9163):1476–1480PubMedCrossRef Ellis H, Moran BJ, Thompson JN, Parker MC, Wilson MS, Menzies D, McGuire A, Lower AM, Hawthorn RJ, O’Brien F, Buchan S, Crowe AM (1999) Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study. Lancet 353(9163):1476–1480PubMedCrossRef
13.
go back to reference Ellis H (2004) Medicolegal consequences of adhesions. Hosp Med 65(6):348–350PubMed Ellis H (2004) Medicolegal consequences of adhesions. Hosp Med 65(6):348–350PubMed
14.
15.
go back to reference DeWilde RL, Trew G (2007) Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position. Part 2—steps to reduce adhesions. Gynecol Surg 4(4):243–253CrossRef DeWilde RL, Trew G (2007) Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position. Part 2—steps to reduce adhesions. Gynecol Surg 4(4):243–253CrossRef
16.
go back to reference Bhardwaj R, Parker MC (2007) Impact of adhesions in colorectal surgery. Colorectal Dis 9(Suppl 2):45–53PubMedCrossRef Bhardwaj R, Parker MC (2007) Impact of adhesions in colorectal surgery. Colorectal Dis 9(Suppl 2):45–53PubMedCrossRef
17.
go back to reference Cole A (2008) GMC asks doctors to take greater care over consent after law changes. BMJ 336(7654):1152–1153PubMedCrossRef Cole A (2008) GMC asks doctors to take greater care over consent after law changes. BMJ 336(7654):1152–1153PubMedCrossRef
18.
19.
20.
go back to reference Wiseman DM (2008) Disorders of adhesions or adhesion-related disorder: monolithic entities or part of something bigger—CAPPS? Semin Reprod Med 26(4):356–368PubMedCrossRef Wiseman DM (2008) Disorders of adhesions or adhesion-related disorder: monolithic entities or part of something bigger—CAPPS? Semin Reprod Med 26(4):356–368PubMedCrossRef
21.
go back to reference Rajab TK, Wallwiener CW, Brochhausen C, Hierlemann H, Kraemer B, Wallwiener M (2009) Adhesion prophylaxis using a copolymer with rationally designed material properties. Surgery 145(2):196–201PubMedCrossRef Rajab TK, Wallwiener CW, Brochhausen C, Hierlemann H, Kraemer B, Wallwiener M (2009) Adhesion prophylaxis using a copolymer with rationally designed material properties. Surgery 145(2):196–201PubMedCrossRef
22.
go back to reference Murray E, Burns J, See TS, Lai R, Nazareth I (2005) Interactive health communication applications for people with chronic disease. Cochrane Database Syst Rev (4):CD004274 Murray E, Burns J, See TS, Lai R, Nazareth I (2005) Interactive health communication applications for people with chronic disease. Cochrane Database Syst Rev (4):CD004274
Metadata
Title
Patients’ awareness of postoperative adhesions: results from a multi-centre study and online survey
Authors
Bernhard Kraemer
Jennifer C. Birch
Judy V. Birch
Nina Petri
Umar Ahmad
Dilshad Marikar
Markus Wallwiener
Christian Wallwiener
Amanda Foran
Taufiek K. Rajab
Publication date
01-05-2011
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 5/2011
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-010-1504-3

Other articles of this Issue 5/2011

Archives of Gynecology and Obstetrics 5/2011 Go to the issue