Survey of opinions on operative management of adhesive XXXX : laparoscopy versus laparotomy in the state of Connecticut.

@entity1 @entity10634 @entity1744
BACKGROUND: This study sought to know the opinions of general surgeons registered in the state of Connecticut about their use of laparoscopic lysis of adhesions ( @entity10634 ) to manage adhesive @entity1744 ( @entity1744 ) compared with open lysis of adhesions (OLA) in terms of safety, contraindications, and outcomes. METHODS: A questionnaire was designed to gather the opinions of general surgeons registered in Connecticut on this topic. The questionnaire was administered electronically and through the mail. RESULTS: Of the 205 general surgeons to whom the questionnaire was sent, 87 completed it (42% response). The respondents were evenly distributed throughout Connecticut. Of these respondents, 9% were university teaching hospital faculty, 55% were community teaching hospital based, and 36% were community nonteaching hospital based. The answers to the questions were expressed as percentages and differences between groups tested using Fisher's exact test, with the significance level set at a P value less than 0.05. According to their self-reports, 60% of the respondents used @entity10634 in their practice, with 38% of this group using @entity10634 for less than 15% of their adhesive @entity1744 cases. Compared with surgeons out of training less than 15 years, a greater number of surgeons out of training more than 15 years considered @entity10634 to be safer (P = 0.03) and to have better outcomes (P = 0.04) than OLA. More surgeons in academic/teaching settings considered @entity10634 to be safe than did surgeons in nonacademic/nonteaching settings (P = 0.04), and more members of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)/Society of Laparoendoscopic Surgeons (SLS) considered @entity10634 to be safe than nonmembers (P = 0.001). CONCLUSIONS: Many surgeons do not perform @entity10634 for reasons that differ from those in the surgical literature, which supports @entity10634 . Surgeons recently trained or with membership in minimally invasive surgery (MIS) societies are more likely to use @entity10634 . These data suggest that recent training and interest or membership in MIS associations influence surgeons' choice for @entity10634 . This survey demonstrated that an opportunity exists to improve @entity1 outcomes with education about the merits of @entity10634 in the state of Connecticut.
