Predictors of intra-abdominal adhesions

Abstract

The objective of this study is to evaluate the prevalence and predicting factors for intra-abdominal adhesions among 1,050 consecutive cases of laparoscopy. This study is designed as a retrospective cohort study. Multivariate linear regression model was constructed to determine factors associated with increased intra-abdominal adhesions including age, number of previous abdominal operations, and endometriosis. Adhesions were graded using a modified (ASRM) classification for adnexal adhesions. Factors affecting the development of intra-abdominal adhesions were number of previous abdominal operations (P < 0.0001, 95% CI 0.18–0.30) and degree of endometriosis (P < 0.0001, 95% CI 0.25–0.35). Endometriosis had more influence on adhesion formation than number of previous operations as demonstrated by the standardized coefficients beta in endometriosis (0.32) versus previous abdominal operations (0.21). Age, BMI, and PID were not associated with increased abdominal adhesions. Endometriosis and abdominal operations play an important role in development of intra-abdominal adhesions. However, endometriosis has more influence on adhesions than previous operations.