cqvip:Goal: Our aim was to assess the long- term efficacy of diagnostic laparoscop y and adhesiolysis on the treatment of intractable chronic abdominal pain. Study : This was a prospective nonrandomized study of 72 patients (60 women and 12 men ). One surgeon performed a total of 79 diagnostic laparoscopies including 61 adh esiolysis. The patients’ demographic data, operative findings, and long- term postoperative course were carefully recorded. A quality- of- life questionnai re was mailed after the mean follow- up of 3.7 years to find out the late cours e of any chronic abdominal symptoms after the surgery. Results: Intra- abdomina l adhesions were found in 61 patients (85% ) in the laparoscopy, gynecologic di sorders in 4, chronic appendicitis in 1, and no abnormality in 6 patients. The a bdominal wall pain was a likely reason for pain in 12 patients (17% ). The comp lication rate was minimal, including only four bleedings (one major), one perfor ation of urinary bladder, and three wound infections. At 1- month control, 38% of the patients were completely free of pain. In the long- term follow- up, chronic abdominal pain was totally healed in 33% , diminished in 46% , and unc hanged in 21% of the patients. A total of 65 patients (90% ) reported that th e surgery had been beneficial for their intractable pain. Conclusions: By carefu l selection, for patients with chronic abdominal pain, laparoscopy alleviates th e symptoms in more than 70% of the patients, and it should be considered if ot her diagnostics tests are negative. A placebo- controlled study is needed, in w hich the patients are randomized into laparoscopy and conservatively treated gro ups with a quality- of- life measurement.
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