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Adhesion-related readmissions after surgery for deep endometriosis with the use of icodextrin—long-term results

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Gynecological Surgery

Abstract

Icodextrin (Adept®) has been shown to prevent postoperative adhesions in experimental and laparoscopic adhesiolysis surgery. However, the role of icodextrin in the prevention of adhesions in extensive gynecological surgery is unclear. The present study evaluated the effect of icodextrin on adhesion-related readmissions after extensive gynecological surgery. The hospital readmissions of 140 endometriosis patients operated on at Päijät-Häme Central Hospital in 2004–2008 with the use of icodextrin were retrospectively reviewed. The evaluation of readmissions focused on adhesion-related disorders and reoperations. If an abdominal or pelvic reoperation was performed, the extent of the adhesions was classified. The mean follow-up time was 6.53 years (range 0.21–9.83). After initial surgery, one patient (0.7 %) had adhesive small bowel obstruction. Another directly adhesion-related readmission occurred in two patients (1.4 %). The number of readmissions possibly related to adhesions was 3 (2.1 %). Abdominal or pelvic reoperation was performed on 54 patients (38.6 %): 4 in the open surgery group and 50 in the laparoscopic surgery group. The extent of the adhesions among the 54 reoperated patients was as follows: not mentioned in 16 patients, no adhesions in 14, mild in 18, moderate in 5, and severe in 1. There were two (3.7 %) bowel injuries (one enterotomy and one serosal lesion) in reoperations. The incidence of adhesion-related readmissions after the use of icodextrin is relatively low. This favorable result may be partly related to the laparoscopic technique. Despite the use of an anti-adhesion agent, in some patients, the extent of postoperative adhesions is severe.

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Acknowledgments

The authors thank the study coordinator Marjo Soini for her valuable technical help in the data collection and management.

Authors’ contribution

J. Kössi was involved in project development, data management, data analysis, and manuscript writing. K. Julkunen was involved in data collection and manuscript editing. M Setälä was involved in project development, data collection, and manuscript editing. M. Luostarinen was involved manuscript editing.

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Authors and Affiliations

  1. Department of Surgery, Kanta-Häme Central Hospital, Ahvenistontie 20, 13530, Hämeenlinna, Finland

    Jyrki Kössi

  2. Department of Surgery, University of Turku, Turku, Finland

    Jyrki Kössi

  3. Department of Surgery, University of Helsinki, Helsinki, Finland

    Kristiina Julkunen

  4. Department of Obstetrics and Gynecology, Päijät-Häme Central Hospital, Lahti, Finland

    Marjaleena Setälä

  5. Department of Surgery, Päijät-Häme Central Hospital, Lahti, Finland

    Markku Luostarinen

Authors
  1. Jyrki Kössi
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  2. Kristiina Julkunen
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  3. Marjaleena Setälä
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  4. Markku Luostarinen
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Corresponding author

Correspondence to Jyrki Kössi.

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No funding.

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The authors declare that they have no competing interests.

Ethical approval

The study was approved by the Ethics Committee of the Joint Authority for Päijät-Häme Social and Health Care. All procedures performed in the study were in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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According to the ethical standards of the institutional and national research committee, informed consent was not necessary in this kind of patient file-based study.

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Kössi, J., Julkunen, K., Setälä, M. et al. Adhesion-related readmissions after surgery for deep endometriosis with the use of icodextrin—long-term results. Gynecol Surg 13, 97–102 (2016). https://doi.org/10.1007/s10397-015-0927-z

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  • DOI: https://doi.org/10.1007/s10397-015-0927-z

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