MP26-08 PREDICTORS OF ABDOMINAL ADHESIONS BEFORE ABDOMINAL SURGERY: DEVELOPMENT OF A CLINICAL NOMOGRAM

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP26-08 PREDICTORS OF ABDOMINAL ADHESIONS BEFORE ABDOMINAL SURGERY: DEVELOPMENT OF A CLINICAL NOMOGRAM Olivia Alessandra Voglino, Giorgio Guarnotta, Elisa Mancini, Carmen Gravina, Riccardo Lombardo, Giorgia Tema, Antonio Francesco Maria Cicione, Giovanni Di Pierro, Giorgio Franco, Costantino Leonardo, Alessandro Sciarra, Stefano Salciccia, Antonio Carbone, Antonio Luigi Pastore, Di Marco Massimiliano, Andrea Tubaro, and Cosimo De Nunzio Olivia Alessandra VoglinoOlivia Alessandra Voglino More articles by this author , Giorgio GuarnottaGiorgio Guarnotta More articles by this author , Elisa ManciniElisa Mancini More articles by this author , Carmen GravinaCarmen Gravina More articles by this author , Riccardo LombardoRiccardo Lombardo More articles by this author , Giorgia TemaGiorgia Tema More articles by this author , Antonio Francesco Maria CicioneAntonio Francesco Maria Cicione More articles by this author , Giovanni Di PierroGiovanni Di Pierro More articles by this author , Giorgio FrancoGiorgio Franco More articles by this author , Costantino LeonardoCostantino Leonardo More articles by this author , Alessandro SciarraAlessandro Sciarra More articles by this author , Stefano SalcicciaStefano Salciccia More articles by this author , Antonio CarboneAntonio Carbone More articles by this author , Antonio Luigi PastoreAntonio Luigi Pastore More articles by this author , Di Marco MassimilianoDi Marco Massimiliano More articles by this author , Andrea TubaroAndrea Tubaro More articles by this author , and Cosimo De NunzioCosimo De Nunzio More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003254.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Intraabdominal adhesions are nonspecific complications related to prior abdominal surgery. Aim of our study was to evaluate the possible preoperative predictors of abdominal adhesions. METHODS: A consecutive series of patients undergoing abdominal surgery were prospectively enrolled from January 2021 to October 2022. Patients were preoperatively evaluated with clinical history and physical examination. A contrast enhanced CT scan was performed before the procedure and on the portal phase intrabdominal adhesions were recorded. Intraoperative adhesions were graded according to the peritoneal carcinomatosis index. Predictors of intraoperative adhesions were evaluated using logistic regression analysis. A nomogram was developed based on the logistic regression model. RESULTS: Overall, 104 patients with a median age of 69 (64/73) were enrolled. On abdominal CT 58/104 ( 56%) presented signs of abdominal adhesions and 46/104 (44%) presented adhesions intraoperatively. Median PCI was 5 (3/7). Patients with intraoperative abdominal adhesions presented more frequently Metabolic Syndrome (37/46: 82% vs 30/58: 51%, p<0,05), previous abdominal surgery (32/46:69% vs 21/58: 37%, p<0,01), ischemic heart disease (IHD) (16/46:36 % vs 9/58: 16 %, p<0,05) and signs of adhesions on abdominal CT (40/46: 87% vs 18/58:31%; p<0,05). On univariate analysis, metabolic syndrome, IHD, prior abdominal surgery and CT adhesions were predictors of intraoperative adhesions. On multivariate analysis, metabolic syndrome, abdominal surgery and CT adhesions were predictors of intraoperative adhesions. We developed a clinical nomogram to predict adhesions with an AUC of 0,85 and a clinical net benefit in the range of probabilities between 20 and 80%. CONCLUSIONS: Metabolic syndrome, prior abdominal surgery and CT adhesions are predictors of intraoperative adhesions. The present nomogram may be used after external validation to counsel patients on the presence of adhesions before abdominal surgery. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e355 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Olivia Alessandra Voglino More articles by this author Giorgio Guarnotta More articles by this author Elisa Mancini More articles by this author Carmen Gravina More articles by this author Riccardo Lombardo More articles by this author Giorgia Tema More articles by this author Antonio Francesco Maria Cicione More articles by this author Giovanni Di Pierro More articles by this author Giorgio Franco More articles by this author Costantino Leonardo More articles by this author Alessandro Sciarra More articles by this author Stefano Salciccia More articles by this author Antonio Carbone More articles by this author Antonio Luigi Pastore More articles by this author Di Marco Massimiliano More articles by this author Andrea Tubaro More articles by this author Cosimo De Nunzio More articles by this author Expand All Advertisement PDF downloadLoading ...