Page 136 - Postoperative Intra-Abdominal Adhesions- New insights in prevention and consequences

Chapter 8
the hospital administration code for diverticulitis with surgical therapy. They were excluded from analyses if postoperative pathology reports showed malignancy instead of diverticulitis. The study design was analogous to an earlier follow-up report of our research group [2]. Data on demography, clinical presentation, histopathology, operative reports, long-term outcomes, and postoperative complications were reviewed. In those cases that medical files were incomplete, the patients were excluded. In 2014, all patients were invited to fill-out a questionnaire by regular mail. All survival data and addresses were checked at the municipal offices and non-responders were contacted again after 6 weeks.
The need for ethical review was waived by the ethical committees of the participating hospitals as it is not required for this type of study in the Netherlands. Informed consent was obtained from all patients who completed the questionnaire.
Definitions
All patients were asked for the presence of abdominal complaints during the last 6 months. These complaints were further specified using the validated gastrointestinal quality of life index questionnaire (GIQLI). Severity of diverticulitis was scored according to the Hinchey classification [12] and timing of surgery. Acute surgery was defined as an operation within 24 hours after admission. Laparoscopy included all laparoscopic procedures, including hand-assisted. Conversion to open surgery was for the long-term results considered as open surgery. Postoperative bowel obstruction was defined as passage problems requiring placement of a nasogastric tube.
Questionnaire
The questionnaire was divided in two parts: part 1 consisted of general questions about re-interventions and abdominal complaints: part 2 consisted of the GIQLI, an established tool for assessing quality of life concerning different gastro-intestinal diseases [13]. This questionnaire can be divided in 4 subscales measuring different aspects of quality of life; physical well-being, mental well-being, digestion and defecation as
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