Is Patient Education About Adhesions a Requirement in Abdominopelvic Surgery?

 

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Abstract

Background: Over the past decades, our knowledge and understanding of adhesions and adhesion-related complications has increasingly grown and it has become evident that adhesions have significant implications for patients, physicians and the healthcare system. The question arises whether this has resulted in greater awareness of adhesion-related problems among practicing physicians and appropriate patient education on this topic in daily practice. The following article provides a brief overview of the important subject of adhesions, discusses current awareness of adhesions among patients and doctors and addresses the consequences of failure to provide patient education and consent from a medical perspective. Methods: Selective literature searches were conducted in PubMed and the Cochrane Library. A patient information and consent form was developed based on several yearsʼ experience and expertise in the field of adhesions. Results: Adhesions are the most common type of complication in abdominopelvic surgery today, with devastating consequences for some patients. Surveys investigating the awareness of adhesions among physicians and patients clearly showed that even well-informed physicians fail to educate their patients adequately. Such failure could potentially lead to successful medical malpractice lawsuits against doctors. Conclusion: Considering their clear clinical impact, adhesions and related consequences should always be discussed with patients preoperatively. A newly developed consent form that specifically addresses adhesion formation may serve to thoroughly educate patients preoperatively and to adequately document the process of doing so.

Zusammenfassung

Hintergrund: In den letzten Jahrzehnten hat das Wissen über Adhäsionen und adhäsionsbedingte Komplikationen stetig zugenommen, wobei gezeigt werden konnte, dass Adhäsionen beträchtliche Folgen für Patienten, Ärzte und das Gesundheitssystem haben. Aufgrund dieser Erkenntnisse stellt sich ärztlicherseits die Frage, ob die Forschungsergebnisse zu einer verstärkten Wahrnehmung von Adhäsionen bei praktisch tätigen Ärzten geführt haben, und es in der Folge auch zu einer verstärkten Aufklärung der Patienten über adhäsionsbedingte Komplikationen gekommen ist. Der vorliegende Artikel gibt einen kurzen Überblick über das wichtige Thema der Adhäsionen und beschäftigt sich mit der Wahrnehmung von Adhäsionen durch Ärzte und Patienten sowie mit den möglichen rechtlichen Konsequenzen einer nicht erfolgten Aufklärung aus ärztlicher Sicht. Methodik: Für die Erstellung des Artikels wurde eine selektive Literaturrecherche in PubMed und der Cochrane Library durchgeführt. Ferner wurde ein Aufklärungsbogen auf der Grundlage langjähriger Erfahrung und Expertise auf dem Gebiet der Adhäsionen entwickelt. Ergebnisse: Adhäsionen sind heutzutage die häufigste Komplikation abdominopelviner Operationen mit z. T. schwerwiegenden Auswirkungen für die betroffenen Patienten. Befragungen bez. der Wahrnehmung von Adhäsionen durch Ärzte und Patienten ergaben, dass selbst gut informierte Ärzte ihre Patienten nicht über adhäsionsbedingte Komplikationen aufklären, obgleich dies rechtliche Konsequenzen haben könnte. Schlussfolgerung: Aufgrund der großen klinischen Bedeutung von Adhäsionen sollten Patienten routinemäßig über Adhäsionen und die potenziell damit verbundenen Komplikationen aufgeklärt werden. Ein neu erstellter Aufklärungsbogen über Adhäsionen kann helfen, Patienten nachweislich und gründlich aufzuklären.

^* Joint first authors and equal contributors.

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