Investigating the Incidence and Management of Postoperative Adhesions in Abdominal Surgery

Background: To determine the incidence, risk factors, and management outcomes of postoperative adhesions in patients undergoing abdominal surgery. Methods: This prospective observational study included 77 patients who underwent elective or emergency abdominal surgery between August 2023 and August 2024. Demographic data, surgical characteristics, and postoperative follow-up findings were recorded. Adhesions were diagnosed through clinical assessment, imaging, or reoperation findings and graded using the Zühlke classification. Management outcomes, including recurrence and postoperative complications, were analyzed. Results: Postoperative adhesions were detected in 28 patients (36.4%). Open surgery was associated with a significantly higher adhesion rate compared to laparoscopic procedures (p = 0.018). Colorectal resections (p = 0.029), operative duration >180 minutes (p = 0.011), and intraoperative complications (p = 0.041) were significant predictors. Small bowel adhesions were most common (46.4%), and 39.3% were classified as severe (Zühlke grade 3–4). Half of the cases were managed conservatively, while half required surgical adhesiolysis, with laparoscopic adhesiolysis resulting in shorter hospital stays (p = 0.041). Adhesion recurrence occurred in 21.4% of surgically treated cases, with no mortality reported. Conclusion: Postoperative adhesions remain a significant burden after abdominal surgery, particularly in open, prolonged, and complicated operations. Preventive measures and early detection in high-risk patients are essential, while laparoscopic adhesiolysis offers favorable recovery when surgical intervention is required..