Kim Young Im, Lee Maria, Kim Se Ik, Seol Aeran, Lee Eun Ji, Kim Hee Seung, Song Yong Sang
Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul 03080, Korea.
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 03080, Korea.
J Clin Med. 2020 Jul 16;9(7):2261. doi: 10.3390/jcm9072261.
Postoperative abdominal adhesions can lead to several adverse consequences such as pelvic pain, bowel obstruction, and infertility. We aimed to explore the anti-adhesion efficacy and safety of a thermo-sensitive sol-gel agent in patients who receive abdominopelvic surgery for benign gynecologic disease. This study was a randomized, controlled, single-blind clinical trial of women undergoing benign gynecologic surgery between January 2017 and December 2017. The patients were randomly assigned to three groups with a 1:1:1 ratio: experimental group (received the thermo-sensitive sol-gel agent), control group (untreated), and comparator group (received 4% icodextrin). Patients were followed for 4 weeks postoperatively, and efficacy was evaluated by performing the visceral slide test to identify adhesion formation. In total, 183 patients were enrolled in the study, and 178 (97.3%) completed the trial. The incidence rate of abdominal adhesion formation was significantly lower in the experimental group than in the control group (7.9% vs. 21.1%, = 0.040); however, it was similar between the experimental and comparator groups (7.9% vs. 13.8%. = 0.299). At 4 weeks, no differences in adhesion-related symptoms were observed between the experimental and control groups. Adverse events were mostly mild and did not differ significantly among the three groups ( = 0.375). In conclusion, use of a thermo-sensitive sol-gel agent was safe and effective to prevent abdominal adhesions after benign gynecologic surgeries.
术后腹腔粘连可导致多种不良后果,如盆腔疼痛、肠梗阻和不孕。我们旨在探讨一种热敏性溶胶-凝胶剂在接受良性妇科疾病腹盆腔手术患者中的抗粘连疗效及安全性。本研究是一项针对2017年1月至2017年12月期间接受良性妇科手术的女性进行的随机、对照、单盲临床试验。患者按1:1:1的比例随机分为三组:实验组(接受热敏性溶胶-凝胶剂)、对照组(未治疗)和比较组(接受4%艾考糊精)。术后对患者进行4周随访,通过进行内脏滑动试验来评估粘连形成情况,以评价疗效。共有183例患者纳入本研究,178例(97.3%)完成试验。实验组腹腔粘连形成的发生率显著低于对照组(7.9%对21.1%,P = 0.040);然而,实验组与比较组之间相似(7.9%对13.8%,P = 0.299)。在4周时,实验组与对照组之间未观察到粘连相关症状的差异。不良事件大多为轻度,三组之间无显著差异(P = 0.375)。总之,使用热敏性溶胶-凝胶剂预防良性妇科手术后腹腔粘连是安全有效的。