Adhesion formation after intracapsular myomectomy with or without adhesion barrier
To show the prevention of adhesion formation by placing an absorbable adhesion barrier after intracapsular myomectomy. Prospective blinded observational study. University-affiliated Hospitals. Patients ≥18 years old with single or multiple uterine fibroids removed by laparoscopic or abdominal intrac...
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| Published in | Fertility and sterility Vol. 95; no. 5; pp. 1780 - 1785 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
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New York, NY
Elsevier Inc
01.04.2011
Elsevier |
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| Online Access | Get full text |
| ISSN | 0015-0282 1556-5653 1556-5653 |
| DOI | 10.1016/j.fertnstert.2010.12.049 |
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| Abstract | To show the prevention of adhesion formation by placing an absorbable adhesion barrier after intracapsular myomectomy.
Prospective blinded observational study.
University-affiliated Hospitals.
Patients ≥18 years old with single or multiple uterine fibroids removed by laparoscopic or abdominal intracapsular myomectomy.
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.
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.
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.
Oxidized regenerated cellulose reduces postsurgical adhesions. Cohesive adhesions reduction was noted in laparoscopy. |
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| AbstractList | OBJECTIVE: To show the prevention of adhesion formation by placing an absorbable adhesion barrier after intracapsular myomectomy. DESIGN: Prospective blinded observational study. SETTING: 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. To show the prevention of adhesion formation by placing an absorbable adhesion barrier after intracapsular myomectomy.OBJECTIVETo show the prevention of adhesion formation by placing an absorbable adhesion barrier after intracapsular myomectomy.Prospective blinded observational study.DESIGNProspective blinded observational study.University-affiliated Hospitals.SETTINGUniversity-affiliated Hospitals.Patients ≥ 18 years old with single or multiple uterine fibroids removed by laparoscopic or abdominal intracapsular myomectomy.PATIENT(S)Patients ≥ 18 years old with single or multiple uterine fibroids removed by laparoscopic or abdominal intracapsular myomectomy.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.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.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.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.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.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.Oxidized regenerated cellulose reduces postsurgical adhesions. Cohesive adhesions reduction was noted in laparoscopy.CONCLUSION(S)Oxidized regenerated cellulose reduces postsurgical adhesions. Cohesive adhesions reduction was noted in laparoscopy. To show the prevention of adhesion formation by placing an absorbable adhesion barrier after intracapsular myomectomy. Prospective blinded observational study. University-affiliated Hospitals. Patients ≥18 years old with single or multiple uterine fibroids removed by laparoscopic or abdominal intracapsular myomectomy. 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. 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. 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. Oxidized regenerated cellulose reduces postsurgical adhesions. Cohesive adhesions reduction was noted in laparoscopy. To show the prevention of adhesion formation by placing an absorbable adhesion barrier after intracapsular myomectomy. Prospective blinded observational study. University-affiliated Hospitals. Patients ≥ 18 years old with single or multiple uterine fibroids removed by laparoscopic or abdominal intracapsular myomectomy. 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. 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. 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. Oxidized regenerated cellulose reduces postsurgical adhesions. Cohesive adhesions reduction was noted in laparoscopy. |
| Author | Stark, Michael Malvasi, Antonio Hurst, Brad Mettler, Liselotte Hudelist, Gernot Guido, Marcello Tinelli, Andrea Tsin, Daniel Alberto |
| Author_xml | – sequence: 1 givenname: Andrea surname: Tinelli fullname: Tinelli, Andrea email: andreatinelli@gmail.com organization: Department of Obstetrics and Gynecology, Vito Fazzi Hospital, Lecce, Italy – sequence: 2 givenname: Antonio surname: Malvasi fullname: Malvasi, Antonio organization: Department of Obstetrics and Gynecology, Santa Maria Hospital, Bari, Italy – sequence: 3 givenname: Marcello surname: Guido fullname: Guido, Marcello organization: Laboratory of Hygiene, Department of Biologic and Environmental Sciences and Technologies, Faculty of Sciences, University of Salento, Lecce, Italy – sequence: 4 givenname: Daniel Alberto surname: Tsin fullname: Tsin, Daniel Alberto organization: Department of Minimally Invasive Surgery, The Mount Sinai Hospital of Queens, Long Island City, New York – sequence: 5 givenname: Gernot surname: Hudelist fullname: Hudelist, Gernot organization: Department of Obstetrics and Gynecology, Wilhelminen Hospital, University of Vienna, Vienna, Austria – sequence: 6 givenname: Brad surname: Hurst fullname: Hurst, Brad organization: Assisted Reproduction Center, Carolinas Medical Center, Charlotte, North Carolina – sequence: 7 givenname: Michael surname: Stark fullname: Stark, Michael organization: New European Surgical Academy, Berlin, Germany – sequence: 8 givenname: Liselotte surname: Mettler fullname: Mettler, Liselotte organization: Kiel School of Gynecologic Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Kiel, Germany |
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| Copyright | 2011 American Society for Reproductive Medicine American Society for Reproductive Medicine 2015 INIST-CNRS Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved. |
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| Keywords | intracapsular myomectomy laparoscopy adhesiolysis fibroid adhesion prevention fertility uterine leyomyoma Interceed pelvic pain Adhesion oxidized regenerated cellulose Myoma myomectomy Gynecology Cellulose Laparoscopy Fibroma Pelvic pain Obstetrics Prevention Uterus Fertility Oxidation Benign neoplasm Endoscopy Formation |
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| Snippet | To show the prevention of adhesion formation by placing an absorbable adhesion barrier after intracapsular myomectomy.
Prospective blinded observational study.... Objective To show the prevention of adhesion formation by placing an absorbable adhesion barrier after intracapsular myomectomy. Design Prospective blinded... OBJECTIVE: To show the prevention of adhesion formation by placing an absorbable adhesion barrier after intracapsular myomectomy. DESIGN: Prospective blinded... To show the prevention of adhesion formation by placing an absorbable adhesion barrier after intracapsular myomectomy.OBJECTIVETo show the prevention of... |
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| SubjectTerms | adhesiolysis Adhesion adhesion prevention Adult Biological and medical sciences cellulose Digestive system. Abdomen Endoscopy Female fertility fibroid Gynecologic Surgical Procedures - adverse effects Gynecologic Surgical Procedures - methods Gynecologic Surgical Procedures - rehabilitation Gynecology. Andrology. Obstetrics hospitals Humans Incidence Interceed Internal Medicine intracapsular myomectomy Investigative techniques, diagnostic techniques (general aspects) laparoscopy Laparoscopy - adverse effects Laparoscopy - methods Laparoscopy - rehabilitation laparotomy Leiomyoma - epidemiology Leiomyoma - pathology Leiomyoma - surgery Medical sciences observational studies Obstetrics and Gynecology oxidized regenerated cellulose patients pelvic pain Severity of Illness Index Single-Blind Method Tissue Adhesions - epidemiology Tissue Adhesions - etiology Tissue Adhesions - pathology uterine leyomyoma Uterine Neoplasms - epidemiology Uterine Neoplasms - pathology Uterine Neoplasms - surgery women Young Adult |
| Title | Adhesion formation after intracapsular myomectomy with or without adhesion barrier |
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