Documento de consenso del Grupo de Trabajo sobre las Adherencias de la sección de endoscopia de la SEGO

Abstract

Adhesions are the most frequent complication of abdominopelvic surgery. These complications have major short- and long-term consequences, including infertility, chronic pelvic pain and a lifetime risk of small bowel obstruction. Adhesions complicate future surgery, leading to high associated morbidity and expense and a considerable risk of mortality. Despite advances in surgical techniques, the burden of adhesion-related complications has remained unchanged in recent years. Adhesiolysis is still the main treatment, although adhesions reform in most patients. This consensus position provides a comprehensive overview of adhesions and their consequences and describes practical proposals for actions that gynecological surgeons in Spain should take. Developments in adhesion-reduction strategies and new agents offer a realistic possibility of reducing adhesion formation and improving patient outcomes. These strategies should be adopted at least in high risk surgery and in patients with predisposing factors. Patients also need to be made more aware of the risks of adhesions and their potential consequences.