Long-term outcomes and quality of life after laparoscopic adhesiolysis for chronic abdominal pain

Abstract

Study objective: To evaluate clinical outcome in terms of pain and quality of life after laparoscopic adhesiolysis.

Design: Prospective observational study (Canadian Task Force II-3).

Setting: University-affiliated medical center.

Patients: Twenty-three patients (22 women).

Intervention: Laparoscopic adhesiolysis for chronic abdominal pain.

Measurements and main results: Pain was assessed by validated McGill score. Patients with an intraindividual decrease in pain score of 5 points or more were considered successes. Quality of life was assessed by the SF-36 and gastrointestinal quality of life index. Patients were evaluated before and at intervals until 2 years after adhesiolysis. The mean pain score before adhesiolysis was 30.5 (range: 17-40). At 2 years of follow-up, 10 (45%) of 22 patients (95% CI 0.244-0.678) were considered successes. They reported significant improvement in quality of life on scales physical, role physical, and social function, and fewer gastrointestinal symptoms. Twelve women (55%) had a complete relapse, and most were not motivated to visit the pain clinic after 6 months.

Conclusion: Laparoscopic adhesiolysis for chronic abdominal pain was successful in only 45% of patients.