Abstract
Objective:
Postoperative adhesions after laparoscopic myomectomy (LM) are a significant clinical problem. Use of adhesion barriers was suggested as a preventive measure. The present study was conducted to assess the role of intraoperative oxidized regenerated cellulose (Surgicel®; Ethicon USA) for preventing postoperative adhesions in women undergoing LM.
Materials and Methods:
The study included 114 women with previous LM who underwent various kinds of open and laparoscopic surgeries after LM. The study included 57 patients who agreed to use the surgical-adhesions barrier (a Surgicel group) and 57 patients who did not use the adhesion barrier product (control group). To reduce bias related to unbalanced patients' selection, a propensity score-matching analysis was performed.
Results:
Comparison between the 2 groups regarding frequency of adhesions revealed a significantly lower frequency of adhesions in the Surgicel group (12.3% versus 31.6%; p = 0.013). Comparison between the groups regarding the type of adhesions showed a higher frequency of filmy adhesions in the Surgicel group. However, the difference was not statistically significant. Logistic regression analysis identified previous cesarean section (odds ratio [OR]: 0.16; confidence interval [CI]: 0.06–0.45; p = 0.001) and lack of Surgicel use (OR: 0.28; CI: 0.1–0.78; p = 0.015) as significant predictors of postoperative adhesions development.
Conclusions:
The present study suggests that use of Surgicel adhesion barrier with LM is associated with lower frequency and severity of postoperative adhesions. (J GYNECOL SURG 38:111)
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