Skip to main content

Contributions of Adhesions to the Cost of Healthcare

  • Chapter
Peritoneal Surgery

Abstract

Postoperative abdominal adhesions are associated with numerous complications, including small-bowel obstruction, 1 difficult and dangerous reoperations, infertility, and chronic pain.2–5 The healthcare industry has changed dramatically in the past decade. Historically, quality of care was the primary determinant of change in healthcare; however, cost has become a major motivating force in clinical decision making. Despite continued efforts to optimize outcomes, adverse sequelae ensue in all aspects of medicine and surgery. As technology advances, new drugs, devices, and procedures spawn new concerns relating to adverse outcomes. The costs of these unwanted effects contribute significantly to the global costs of healthcare.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Menzies D. Peritoneal adhesions: incidence, cause and prevention. Ann Surg 1992; 24(part l):29–45.

    Google Scholar 

  2. Caspi E, Halpern Y, Bukosky I. The importance of peritoneal adhesions in tubal reconstructive surgery for infertility. Fertil Steril 1979; 31:296–300.

    PubMed  CAS  Google Scholar 

  3. Diamond E. Lysis of postoperative pelvic adhesions in infertility. Fertil Steril 1979; 31:287–295.

    PubMed  CAS  Google Scholar 

  4. Frantzen C, Schlosser HW. Microsurgery and postinfec-tious tubal infertility. Fertil Steril 1982; 38:397–420.

    PubMed  CAS  Google Scholar 

  5. Tulandi T. Salpingo-ovariolysis: a comparison between laser surgery and electrosurgery. Fertil Steril 1986; 45:489–491.

    PubMed  CAS  Google Scholar 

  6. Bryant T. Clinical lectures on intestinal obstruction. Med Times Gazette 1872; 1:363.

    Google Scholar 

  7. Battle WH. Intestinal obstructions coming 4 years after the operation of ovariotomy. Lancet 1883; 1:818.

    Google Scholar 

  8. Vick RM. Statistics of acute intestinal obstruction. Br Med J 1932; 2:546–548.

    Article  PubMed  CAS  Google Scholar 

  9. Waldron GW, Hampton JM. Intestinal obstruction: a half century comparative analysis. Ann Surg 1961; 153:839–850.

    Article  PubMed  CAS  Google Scholar 

  10. P. Nemir Jr. Intestinal obstruction: ten year survey at the hospital of the University of Pennsylvania. Ann Surg 1952; 135:367–375.

    Article  PubMed  Google Scholar 

  11. Perry JF, Smith GA, Yonehiro EG. Intestinal obstruction caused by adhesions: a review of 388 cases. Ann Surg 1955; 142:810–816.

    Article  PubMed  Google Scholar 

  12. Ellis H. The etiology of post-operative abdominal adhesions. An experimental study. Br J Surg 1962; 50:10–16.

    Article  PubMed  CAS  Google Scholar 

  13. Ellis H. The cause and prevention of post-operative intra-peritoneal adhesions. Surg Gynecol Obstet 1971; 133(3):497–511.

    PubMed  CAS  Google Scholar 

  14. Jagelman DG, Ellis H. Starch and intraperitoneal adhesion formation. Br J Surg 1973; 60(2):111–114.

    Article  PubMed  CAS  Google Scholar 

  15. Raf EL. Causes of abdominal adhesions in cases of intestinal obstruction. Act Chir Scand 1969; 135:73.

    CAS  Google Scholar 

  16. Myllarniemi H. Foreign material in adhesion formation after abdominal surgery. Acta Chir Scand 1967;(suppl) 377:13–48.

    CAS  Google Scholar 

  17. Goldman IL, Rosemond PG. Fluorouracil inhibition of experimental peritoneal adhesions. Am J Surg 1967; 113(4):491–493.

    Article  PubMed  CAS  Google Scholar 

  18. Buckman R, Buckman PD, Hufnagel HV, Gervin AS. A physiological basis for the adhesion-free healing of deperi-tonealized surfaces. J Surg Res 1976; 21(2):67–76.

    Article  PubMed  Google Scholar 

  19. Buckman R, Woods M, Sargeant I, Gerwin SA. A unifying mechanism in the etiology of intraperitoneal adhesions. J Surg Res 1976; 20(1):1–5.

    Article  PubMed  CAS  Google Scholar 

  20. Raftery TA. Effect of peritoneal trauma on peritoneal fi-brinolytic activity and intraperitoneal adhesion formation. An experimental study in the rat. Eur Surg Res 1981; 13(6):397–401.

    Article  CAS  Google Scholar 

  21. Playforth RH, Holloway JB, Griffin WO. Mechanical small bowel obstruction: a plea for early surgical intervention. Ann Surg 1970; 171:783–788.

    Article  PubMed  CAS  Google Scholar 

  22. Laws HL. Management of small bowel obstruction. Am Surg 1978; 44:313–317.

    PubMed  CAS  Google Scholar 

  23. Stewardson RH, Bombeck CT, Nyhus LM. Critical operative management of small bowel obstruction. Ann Surg 1978;189–193.

    Google Scholar 

  24. Munro A, Jones PR Operative intubation in the treatment of complicated small bowel obstruction. BrJ Surg 1978; 65(2):123–127.

    Article  CAS  Google Scholar 

  25. Menzies D, Ellis H. Intestinal obstruction from adhesions—how big is the problem? Ann R Coll Surg Engl 1990; 72:60–63.

    PubMed  CAS  Google Scholar 

  26. Ray NF, Larsen JW Jr, Stillman RJ, Jacobs RJ. Economic impact of hospitalizations for lower abdominal adhesiolysis in the United States in 1988. Surg Gynecol Obstet 1993; 176(3):271–276.

    PubMed  CAS  Google Scholar 

  27. Ray NF, Denton WG, Thamer M, Henderson SC, Perry S. Abdominal adhesiolysis: inpatient care and expenditures in the United States in 1994. J Am Coll Surg 1998; 186(1):1–9.

    Article  PubMed  CAS  Google Scholar 

  28. Wiseman D. Polymers for the prevention of surgical adhesions. In: Domb AJ, ed. Polymeric Site-Specific Pharma-cotherapy. New York: Wiley, 1994:370–421.

    Google Scholar 

  29. Beck DE. The role of Seprafilm™bioresorbable membrane in adhesion prevention. Eur J Surg 1997; 7:49–55.

    Google Scholar 

  30. Becker MJ, Dayton LM, Fazio WV, et al. Prevention of postoperative abdominal adhesions by sodium hyaluronate-based bioresorbable membrane: a prospective, randomized, double-blind multicenter study. J Am Coll Surg 1996; 183:297–306.

    PubMed  CAS  Google Scholar 

  31. Weibel MA, Majno G. Peritoneal adhesions and their relation to abdominal surgery. Am Chir Scand 1969; 135:73–76.

    Google Scholar 

  32. Ellis H, Parker MC, Menzies D, et al. The surgical impact of adhesions. American Society of Colon and Rectal Surgeons (ASCRS) 97th Annual Convention, 1998, San Antonio, TX, Abstract C75.

    Google Scholar 

  33. Scott-Coombes DM, Thompson JN, Vipond MN. General surgeon’s attitudes to the treatment and prevention of abdominal surgery. Am J Surg 1973; 126:345–353.

    Article  Google Scholar 

  34. Holmdahl L, Risberg B. Adhesions: prevention and complications in general surgery. Eur J Surg 1997; 163:169–174.

    PubMed  CAS  Google Scholar 

  35. Ivarsson ML, Holmdahl L, Franzjen G, Reisberg B. Cost of bowel obstruction resulting from adhesions. Eur J Surg 1997; 163(9):679–684.

    PubMed  CAS  Google Scholar 

  36. Health Care Financing Administration. MEDPAR Database www.hcfa.gov/stats/medpar/medpar.htm www.hcfa.gov/stats/medpar/medpar.htm 1990-1996.

    Google Scholar 

  37. Malcolm W. The surgical impact of adhesions. The surgical and clinical adhesions research study (SCAR). Abstract presented at the annual scientific meeting of Association of Surgeons of Great Britain and Ireland (ASGBI), 13th–15th May, Scotland, 1998.

    Google Scholar 

  38. McGuire A. The economic impact of post-operative adhesions. In: Clinical and epidemiological perspectives on post-operative adhesions. Abstract presented at the annual scientific meeting of Association of Surgeons of Great Britain and Ireland (ASGBI), 13th–15th May, Scotland, 1998.

    Google Scholar 

  39. Moran BJ. The workload from adhesions in re-operative surgery. In: Clinical and epidemiological perspectives on post-operative adhesions. Abstract presented at the annual scientific meeting of Association of Surgeons of Great Britain and Ireland, 13th–15th May, Scotland, 1998.

    Google Scholar 

  40. van Goor H. Complications in re-operated patients. Prevention and treatment of adhesive complications in colorectal surgery. Abstract presented at the International Society of University Colon and Rectal Surgeons (ISURS). XVIIth Biennial Congress, 7th–11th June, Malmo, Sweden, 1998.

    Google Scholar 

  41. Wexner S, Beck D, Seprafilm® Compassionate Use Study Group. Clinical resolution of life-threatening recurrent adhesive disease by Seprafilm®: a compassionate use treatment series (Abstract). Dis Colon Rectum 1998; 41:A58.

    Google Scholar 

  42. Salum M, Weiss EG, Nogueras JJ, Wexner SD. Early obstructive and septic complications with hyaluronate-based membrane in colorectal surgery (Abstract). Dis Colon Rectum 1998; 41:A45.

    Google Scholar 

  43. Salum MR, Batista O, Baig MK, et al. Does the sodium hyaluronate and carboxymethylcellulose membrane (HCM) reduce the incidence and/or severity of small bowel obstruction (SBO)? (Abstract) Colorectal Disease 1999; 1(suppl 1):59.

    Google Scholar 

  44. Moreira H Jr, Yamaguchi T, Choi J, Sardinha C, Billoti V, Wexner S. Safety of sodium hyaluronate-based membrane (Seprafilm™) after bowel injury: a prospective randomized trial (Abstract). Dis Colon Rectum 1998; 41:A6.

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2000 Springer Science+Business Media New York

About this chapter

Cite this chapter

Moscowitz, I., Wexner, S.D. (2000). Contributions of Adhesions to the Cost of Healthcare. In: diZerega, G.S. (eds) Peritoneal Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1194-5_30

Download citation

  • DOI: https://doi.org/10.1007/978-1-4612-1194-5_30

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7040-9

  • Online ISBN: 978-1-4612-1194-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics