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

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

Authors

  • Paola Fugazzola General, Emergency and Trauma Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
  • Federico Coccolini | federico.coccolini@gmail.com 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.

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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Published
2017-07-26
Info
Issue
Vol 2, No 2 (2017)
Section
Original Articles
Keywords:
Peritoneal adhesion index, PAI, peritoneal adhesions, Peritoneal Adhesion Index, intestinal occlusion, peritoneal adhesion, bowel obstruction
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How to Cite
1.
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. J Peritoneum [Internet]. 2017Jul.26 [cited 2020Jul.15];2(2). Available from: http://jperitoneum.org/index.php/joper/article/view/61

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