International Adhesions Society

 

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Abstracts

View the full abstracts from your information submitted between December 2002 - March 2003. These results submitted in abstract form and presented at the PAX Congres in Amsterdam in April 2003.


Bowel Obstruction Abstract

THE PATIENT WITH SEVERE ARD (ADHESION RELATED DISORDER); PATTERN OF BOWEL OBSTRUCTION, BOWEL DYSFUNCTION, NUTRITIONAL, SOCIAL AND PHYSICAN ISSUES

Background: Previous studies have documented the incidence and cost of adhesions in the overall population. However, to date no studies have documented the profile of patients suffering with Adhesion Related Disorder (ARD). Method: An internet-based survey was conducted among patients who visit the web site www.adhesions.org, or who have subscribed to its mailing list. Patients reporting a diagnosis of adhesions were asked to complete a survey regarding the numbers of years since diagnosis, the frequency of bowel obstruction, as well as GI disturbances, nutritional status, their ability to work and receive disability benefits and their support structure. Results: 190 patients (20 male, 170 female) completed the survey with the time since diagnosis of 7.7 + 0.5 years. 71% of patients reported having had either a full or partial obstruction, with 9.8 + 0.92 obstructions and mean (geometric) time between obstructions of 0.93 years. 83% of respondents report suffering from chronic pain for which 77% take medication. 63% of these report that the medication worsens their bowel symptoms. 76% of patients report chronic GI disturbances, including 28% with a malabsorption problem. 48% of patients report that they are unable to work due to the problems caused by adhesions, and 46% of these report being unable to obtain disability benefits. 32% of patients reported having received physical/massage therapy and 33% of these reported receiving a benefit. 24% of patients reported that their family relationships had not suffered and that their friends and family were supportive of their condition. 28% of patients reported that their physician was able to help them somewhat, with another 31% reporting that the physician acknowledged the problem but was unable to provide any help. Only 10% of patients reported that their physician did not acknowledge the problem and was unwilling to help. Conclusion: Despite shortcomings inherent in a survey of this kind, a description of the severe ARD patient has been provided for the first time. These data will be useful in devising strategies for the medical, surgical, nutritional, social and financial support of the ARD patient.


Informed Consent Abstract

ADHESIONS AND INFORMED CONSENT: PATIENT AWARENESS OF ADHESIONS PRIOR TO SURGERY

Background: Adhesions are a significant and common complication of surgery, and yet it appears that most patients have never heard of the term. This study set out to ascertain the information provided to patients prior to surgery regarding adhesions. Method: An internet-based survey was conducted among patients who visit the web site of the International Adhesions Society (www.adhesions.org), and/or who have subscribed to its mailing list. Patients who had abdominal or pelvic surgeries were asked to complete a questionnaire regarding the information given to them, if any, prior to surgery regarding adhesions and adhesion barriers. Results were stratified according to whether the procedure was known beforehand to include adhesiolysis. Results: 222 (20 male, 202 female) patients completed the survey adequately concerning 479 procedures. Overall patients reported being informed about adhesions prior to surgery in 25% (119/479) of the procedures they underwent. In only 50 (10.4%) of these were adhesions mentioned as part of the informed consent and in another 69 (14.4%) adhesions were discussed but not part of the consent. Patients reported being given information about adhesions in 54% of procedures involving adhesiolysis (n=161) and in 10% of procedures not involving adhesiolysis. Patients reported being provided with information about adhesion barriers, in 46% and 6% of procedures involving and not involving adhesiolysis respectively. Conclusion: Given the prevalence of adhesions, the frequency of information provided to patients about adhesions and adhesion barriers appeared remarkably low. Information was more forthcoming in adhesiolysis procedures. Despite a number of obvious caveats involved in interpreting a study of this kind, it suggests the pre-operative consultation and consent procedures may offer the ideal opportunity to educate patients about adhesions. This can only benefit both patients and doctors.

 

 

 

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