Department of Obstetrics and Gynecology, Vito Fazzi Hospital, Lecce, Italy.
Fertil Steril. 2011 Apr;95(5):1780-5. doi: 10.1016/j.fertnstert.2010.12.049. Epub 2011 Jan 22.
To show the prevention of adhesion formation by placing an absorbable adhesion barrier after intracapsular myomectomy.
Prospective blinded observational study.
University-affiliated Hospitals.
PATIENT(S): Patients ≥ 18 years old with single or multiple uterine fibroids removed by laparoscopic or abdominal intracapsular myomectomy.
INTERVENTION(S): A total of 694 women undergoing laparoscopic or abdominal myomectomy were randomized for placement of oxidized regenerated cellulose absorbable adhesion barrier to the uterine incision or for control subjects without barriers. The presence of adhesions was assessed in 546 patients who underwent subsequent surgery.
MAIN OUTCOME MEASURE(S): The primary and secondary outcomes of the analysis were the presence and severity of adhesions for four groups: laparotomy with barrier, laparotomy without barrier, laparoscopy with barrier, and laparoscopy without barrier.
RESULT(S): There was a higher rate of adhesions in laparotomy without barrier (28.1%) compared with laparoscopy with no barrier (22.6%), followed by laparotomy with barrier (22%) and laparoscopy with barrier (15.9%). Additionally, the type of adhesions were different, filmy and organized were predominant with an adhesion barrier, and cohesive adhesions were more common without an adhesion barrier.
CONCLUSION(S): Oxidized regenerated cellulose reduces postsurgical adhesions. Cohesive adhesions reduction was noted in laparoscopy.
通过在囊内子宫肌瘤切除术后放置可吸收防粘连屏障来防止粘连形成。
前瞻性盲法观察性研究。
大学附属医院。
年龄≥18 岁，通过腹腔镜或剖腹式囊内子宫肌瘤切除术切除单个或多个子宫肌瘤的患者。
共有 694 名接受腹腔镜或剖腹式子宫肌瘤切除术的女性被随机分为两组，一组在子宫切口处放置氧化再生纤维素可吸收防粘连屏障，另一组为无屏障对照组。对随后接受手术的 546 名患者进行粘连评估。
分析的主要和次要结果是四种情况的粘连存在和严重程度：有屏障的剖腹术、无屏障的剖腹术、有屏障的腹腔镜手术和无屏障的腹腔镜手术。
无屏障剖腹术的粘连发生率（28.1%）高于无屏障腹腔镜手术（22.6%），其次是有屏障剖腹术（22%）和有屏障腹腔镜手术（15.9%）。此外，粘连的类型也不同，有屏障时以膜状和有组织的粘连为主，无屏障时以黏附性粘连为主。
氧化再生纤维素可减少术后粘连。腹腔镜手术中注意到黏附性粘连减少。
