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Postoperative Abdominal Adhesions: Clinical Significance and Advances in Prevention and Management

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Postoperative adhesions remain one of the more challenging issues in surgical practice. Although peritoneal adhesions occur after every abdominal operation, the density, time interval to develop symptoms, and clinical presentation are highly variable with no predictable patterns. Numerous studies have investigated the pathophysiology of postoperative adhesions both in vitro and in vivo. Factors such as type and location of adhesions, as well as timing and recurrence of adhesive obstruction remain unpredictable and poorly understood. Although the majority of postoperative adhesions are clinically silent, the consequences of adhesion formation can represent a lifelong problem including chronic abdominal pain, recurrent intestinal obstruction requiring multiple hospitalizations, and infertility. Moreover, adhesive disease can become a chronic medical condition with significant morbidity and no effective therapy. Despite recent advances in surgical techniques, there is no reliable strategy to manage postoperative adhesions. We herein review the pathophysiology and clinical significance of postoperative adhesions while highlighting current techniques of prevention and treatment.

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  1. Department of Surgery, Ohio State University, Wexner Medical Center, 395 W. 12th Ave., Suite 670, Columbus, OH, USA

    Demetrios Moris, Jeffery Chakedis, Ana Wilson, Eliza W. Beal & Timothy M. Pawlik

  2. Department of Surgery, University of Washington Medical Center, Seattle, WA, USA

    Amir A. Rahnemai-Azar

  3. Department of Surgery, Mercy University Hospital, Grenville Pl, Cork, Ireland

    Mairead Marion Hennessy & Antonios Athanasiou

  4. 1st Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece

    Chrysoula Argyrou & Evangelos Felekouras

Authors
  1. Demetrios Moris
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  2. Jeffery Chakedis
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  3. Amir A. Rahnemai-Azar
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  4. Ana Wilson
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  5. Mairead Marion Hennessy
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  6. Antonios Athanasiou
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  7. Eliza W. Beal
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  8. Chrysoula Argyrou
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  9. Evangelos Felekouras
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  10. Timothy M. Pawlik
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Corresponding author

Correspondence to Timothy M. Pawlik.

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The authors declare that they have no conflicts of interest.

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Moris, D., Chakedis, J., Rahnemai-Azar, A.A. et al. Postoperative Abdominal Adhesions: Clinical Significance and Advances in Prevention and Management. J Gastrointest Surg 21, 1713–1722 (2017). https://doi.org/10.1007/s11605-017-3488-9

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  • DOI: https://doi.org/10.1007/s11605-017-3488-9

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