Pellicano Massimiliano, Bramante Silvia, Cirillo Domenico, Palomba Stefano, Bifulco Giuseppe, Zullo Fulvio, Nappi Carmine
Department of Obstetrics and Gynecology, University of Naples "Federico II", Naples, Italy.
Fertil Steril. 2003 Aug;80(2):441-4. doi: 10.1016/s0015-0282(03)00597-1.
To assess the efficacy of autocrosslinked hyaluronic gel in postsurgical adhesion prevention after laparoscopic myomectomy.
Prospective, randomized, controlled study.
University of Naples "Federico II".Thirty-six infertile women with symptomatic myomas were randomly divided into two groups of 18 patients each.
INTERVENTION(S): Laparoscopic myomectomy with subserous sutures or interrupted figure 8 sutures, with (group A) or without (group B) application of autocrosslinked hyaluronic acid (HA) gel.
MAIN OUTCOME MEASURE(S): Rate of postsurgical adhesions at 60-90 days of follow-up. The rate of subjects who developed postoperative adhesions was significantly lower in group A in comparison with group B (27.8% vs. 77.8%). In both groups, the rate of adhesions was significantly higher in patients treated with interrupted figure 8 sutures than with subserous sutures.
CONCLUSION(S): Autocrosslinked HA gel is a promising resorbable agent barrier for the reduction of postoperative adhesions after laparoscopic myomectomy. Moreover, the type of suture is a factor influencing the postsurgical adhesion formation.
评估自交联透明质酸凝胶在腹腔镜子宫肌瘤剔除术后预防粘连的疗效。
前瞻性、随机、对照研究。
那不勒斯“费德里科二世”大学。36例有症状肌瘤的不孕妇女被随机分为两组，每组18例。
采用腹腔镜子宫肌瘤剔除术，使用浆膜下缝合或间断8字缝合，A组应用自交联透明质酸（HA）凝胶，B组不应用。
随访60 - 90天时的术后粘连发生率。A组术后发生粘连的受试者比例显著低于B组（27.8%对77.8%）。在两组中，采用间断8字缝合治疗的患者粘连发生率显著高于采用浆膜下缝合的患者。
自交联HA凝胶是一种有前景的可吸收性防粘连剂，可减少腹腔镜子宫肌瘤剔除术后的粘连。此外，缝合类型是影响术后粘连形成的一个因素。
