Laparoscopic adhesiolysis--keyhole surgery to treat severe abdominal pain by the removal of adhesions--is controversial and is not based on the outcome of previous research in this area. Dingeman Swank from Groene Hart Hospital, The Netherlands,and colleagues investigated whether laparoscopic adhesiolysis could lead to substantial pain relief and improvement in quality of life in patients with adhesions and chronic abdominal pain.
After diagnostic laparoscopy to confirm adhesions, 100 patients were randomly allocated to receive either laparoscopic adhesiolysis (to remove adhesions) or no intervention. Pain was assessed for 1 year by various methods including a pain change score, use of pain-killers, and a quality of life score.
Although patients in both groups reported substantial pain relief and improved quality of life after one year follow-up, there was no statistical difference in pain relief between the two groups.
Dingeman Swank comments: "Although laparoscopic adhesiolysis is done throughout the world, this procedure is not evidence - based. In view of our findings, we recommend that clinicians consider abandoning laparoscopic adhesiolysis as a treatment for adhesions in patients with chronic abdominal pain."
Contact: Dr D J Swank, Kalmoes 10, 2811 EB Reeuwijk, Netherlands;
T) 31-182-399-205 or 31-620-544-878;
F) 31-182-399-206;
E) djswank@XS4all.nl
Alternative contact: Renee Merkx, 31-182-505-943
Journal
The Lancet