Validation of peritoneal adhesion index as a standardized classification to universalize peritoneal adhesions definition

DOI https://doi.org/10.4081/joper.2017.61

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Published: Jul 26, 2017
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Vol 2, No 2 (2017)
Keywords
Peritoneal adhesion index, PAI, peritoneal adhesions, Peritoneal Adhesion Index, intestinal occlusion, peritoneal adhesion, bowel obstruction
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Fugazzola P, Coccolini F, Nita GE, Montori G, Corbella D, Adesunkanmi AR, Aluffi A, Baiocchi G, Biffl W, Catena F, Celotti A, Cheynel N, Colledan M, Cui Y, Di Saverio S, Faro MPJ, Faruk K, Fraga GP, Gerych I, Gomes CA, Guercioni G, Isik A, Khokha V, Kluger Y, Kong V, Leppaniemi A, Manfredi R, Massalou D, Moore E, Naidoo N, Pereira BMT, Piazzalunga D, Pisano M, Poiasina E, Poletti de Chaurand E, Rat P, Sakakushev B, Sartelli M, Siribumrungwong B, Solaini L, Tomasoni M, Vettoretto N, Yuan K-C, Ansaloni L. Validation of peritoneal adhesion index as a standardized classification to universalize peritoneal adhesions definition. JoPer [Internet]. 26Jul.2017 [cited 21Oct.2019];2(2). Available from: http://jperitoneum.org/index.php/joper/article/view/61
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Paola Fugazzola
General, Emergency and Trauma Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Federico Coccolini *
General, Emergency and Trauma Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Gabriela E. Nita
General, Emergency and Trauma Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Giulia Montori
General and Emergency Surgery Department, Centre Hospitalier Universitaire Bocage, Dijon, France.
Davide Corbella
Anesthesiology Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Abdulrasheed R.K. Adesunkanmi
Department of Surgery, Obafemi Awolowo University Teaching Hospitals, Ile-Ife, Nigeria.
Alessandro Aluffi
Department of Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Gianluca Baiocchi
Department of Surgery, ASST Spedali Civili Brescia, Brescia, Italy.
Walter Biffl
Department of Surgery, University of Colorado, Denver Health Medical Center, Denver, CO, United States.
Fausto Catena
Department of Surgery, Maggiore Hospital, Parma, Italy.
Andrea Celotti
General, Emergency and Trauma Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Nicolas Cheynel
General and Emergency Surgery Department, Centre Hospitalier Universitaire Bocage, Dijon, France.
Michele Colledan
Department of Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Yunfeng Cui
Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China.
Salomone Di Saverio
Department of Surgery, Ospedale Maggiore Carlo Alberto Pizzardi, Bologna, Italy.
Mario Paulo Jr. Faro
Department of General Surgery, Trauma and Emergency Surgery Division, ABC Medical School, Santo André, SP, Brazil.
Karateke Faruk
Department of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey.
Gustavo Pereira Fraga
Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas (Unicamp), Campinas, SP, Brazil.
Igor Gerych
Division of General Surgery, Danylo Halytsky Lviv State Medical University, Ukraine.
Carlos Augusto Gomes
Federal University of Juiz de Fora (UFJF) and Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (SUPREMA), Juiz de Fora, MG, Brazil.
Gianluca Guercioni
Department of Surgery, Ospedale Provinciale Ascoli Piceno, Italy.
Arda Isik
Department of Surgery, Mengucek Gazi Training Research Hospital, Erzincan, Turkey.
Vladimir Khokha
Mozyr City Hospital, Mozyr, Belarus.
Yoram Kluger
Department of General Surgery, Division of Surgery, Rambam Health Care Campus, Haifa, Israel.
Victor Kong
Department of Surgery, Edendale Hospital, Pietermaritzburg, South Africa.
Ari Leppaniemi
Abdominal Center, University Hospital Meilahti, Helsinki, Finland.
Roberto Manfredi
General, Emergency and Trauma Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Damien Massalou
University of Nice-Sophia Antipolis, Faculty of Medicine, Nice, France.
Eugeene Moore
Department of Surgery, University of Colorado, Denver Health Medical Center, Denver, CO, United States.
Noel Naidoo
Port Shepstone Regional Hospital, Port Shepstone, South Africa.
Bruno Monteiro Tavares Pereira
Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas (Unicamp), Campinas, SP, Brazil.
Dario Piazzalunga
General, Emergency and Trauma Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Michele Pisano
General, Emergency and Trauma Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Elia Poiasina
General, Emergency and Trauma Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Eugenio Poletti de Chaurand
General, Emergency and Trauma Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Patrick Rat
General and Emergency Surgery Department, Centre Hospitalier Universitaire Bocage, Dijon, France.
Boris Sakakushev
First Clinic of General Surgery, University Hospital/UMBAL/St George Plovdiv, Plovdiv, Bulgaria.
Massimo Sartelli
Department of Surgery, Macerata Hospital, Macerata, Italy.
Boonying Siribumrungwong
Department of Surgery, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathum Thani, Thailand.
Leonardo Solaini
General, Emergency and Trauma Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Matteo Tomasoni
General, Emergency and Trauma Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Nereo Vettoretto
General and vascular Surgery-M.Mellini Hospital, Chiari (BS), Italy.
Kuo-Ching Yuan
Department of Traumatology and Emergency Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, Province of China.
Luca Ansaloni
General, Emergency and Trauma Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
(*) Corresponding Author:
Federico Coccolini | federico.coccolini@gmail.com

Abstract

Peritoneal adhesion index (PAI) is a score based on appearance and distribution of peritoneal adhesions. The study aims to assess the validity of PAI in order to standardize the definition of peritoneal adhesions. The study includes an expert survey to assess the feasibility of the score and a prospective observational and multicenter trial to assess its validity. 96% of surgeons of the survey consider PAI a useful tool. From January 2013 to March 2015, 205 patients were enrolled to undergo a surgical intervention for bowel obstruction caused by peritoneal adhesions in 21 centers. PAI was significantly higher in the population with previous surgery (P=0.043) and in patients who underwent two previous surgical interventions, if compared to those with only one previous intervention (P=0.012). Length of surgery was significantly longer in patients with higher PAI (P<0.001). Patients with a higher PAI showed a clinically higher risk for early bowel re-obstruction and for early re-intervention. The AUC of the ROC curve for early re-occlusion is 0.8. PAI can be considered a feasible and useful score.

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