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- Title
Surgical Treatment and Perioperative Management of Idiopathic Abdominal Cocoon: Single-Center Review of 65 Cases.
- Authors
Li, Ning; Zhu, Weiming; Li, Yi; Gong, Jianfeng; Gu, Lili; Li, Min; Cao, Lei; Li, Jieshou
- Abstract
Background: The abdominal cocoon (AC) is a condition in which a variable length of healthy small bowel is enveloped in a fibrocollagenous membrane, giving the appearance of a cocoon. Early experiences with treatment were associated with high mortality and morbidity rates and a low preoperative diagnostic rate, leading to underestimation of the treatment benefit of surgery. Methods: We retrospectively reviewed the medical records of 65 patients who were diagnosed as having AC from 2001 to 2011. The clinical data, surgical intervention, and perioperative management were carefully reviewed. Results: The 65 patients (57 male, 8 female) had a median age of 39 years (range 14-79 years). Patients who received preoperative nutritional support had higher rate of grade 0 complications ( p = 0.012) and a lower rate of grade II complications ( p = 0.012) than those without nutritional support. Intestinal stenting during surgical intervention also decreased both grade I ( p = 0.012) and grade II ( p = 0.007) complications. Patients who received preoperative nutritional support and underwent intestinal stenting had a lower rate of postoperative complications ( p < 0.05). In addition, patients with preoperative nutritional support were more satisfied postoperatively ( p = 0.018) than those without nutritional support. This was also observed in patients with intestinal stenting versus those without it ( p = 0.027). Conclusions: Our single-center study with a large number of patients provided evidence regarding the epidemiology of AC. Preoperative nutritional support and intestinal stenting significantly reduced postoperative complications and, more importantly, increased postoperative satisfaction.
- Subjects
ABDOMINAL abnormalities; COLLAGEN; PREOPERATIVE care; SURGICAL complications; INTESTINAL abnormalities; SURGICAL stents
- Publication
World Journal of Surgery, 2014, Vol 38, Issue 7, p1860
- ISSN
0364-2313
- Publication type
Article
- DOI
10.1007/s00268-014-2458-6