Adhesions in abdomino-pelvic surgeries: A real economic impact?

Study objective: To evaluate the epidemiologic and economic burden related to adhesions and their complications for the French healthcare system. Design: A descriptive and economic retrospective analysis. Setting: Medicalized information system program (PMSI), national scale of costs. Patients: Female patients operated on to treat adhesions related complications in 2019. Interventions: All patients with coded adhesiolysis acts were selected in order to identify the characteristics of Diagnosis related groups (DRG) and compare them with the general DRGs. Then, a sub-analysis on surgery types (laparoscopy or open procedures) was performed to evaluate impact adhesions development and Length of Stay. Lastly, direct costs of adhesions for the healthcare system were quantified based upon adhesiolysis acts coded as main diagnosis. Measurements and main results: 26.387 adhesiolysis procedures were listed in France in 2019 through 8 adhesiolysis acts regrouping open surgeries and laparoscopic procedures. Adhesiolysis was coded in up to 34% in some DRGs for laparoscopic procedures. 1551 (1461 studied in our study) surgeries have been realized in 2019 with main procedure: adhesiolysis. These surgeries were associated with an expense of €4 million for the healthcare system for rehospitalizations and reoperations only. Social costs such as sick leaves, drugs and other cares haven’t been taken in consideration. Conclusion: Adhesions related complications represent a massive burden for patients and an expensive problem for society. These difficulties may likely to be reduced by a broader use of antiadhesion barriers, at least in some targeted procedures.