Burden of adhesions in abdominal and pelvic surgery: systematic review and met-analysis

To estimate the disease burden of the most important complications of postoperative abdominal adhesions: small bowel obstruction, difficulties at reoperation, infertility, and chronic pain.

Systematic review and meta-analyses. DATA SOURCES: Searches of PubMed, Embase, and Central, from January 1990 to December 2012, without restrictions to publication status or language. STUDY SELECTION: All types of studies reporting on the incidence of adhesion related complications were considered. DATA EXTRACTION AND ANALYSIS: The primary outcome was the incidence of adhesive small bowel obstruction in patients with a history of abdominal surgery. Secondary outcomes were the incidence of small bowel obstruction by any cause, difference in operative time, enterotomy during adhesiolysis, and pregnancy rate after abdominal surgery. Subgroup and sensitivity analyses were done to study the robustness of the results. A random effects model was used to account for heterogeneity between studies.