title: Evaluation of adhesion formation after laparoscopic myomectomy by systematic second-look microlaparoscopy.
abstract: OBJECTIVE
  To evaluate adhesion formation after laparoscopic myomectomy by second-look laparoscopy using a microlaparoscope.
  
  
  METHODS
  Prospective, nonrandomized study. (Canadian Task Force classification II-1).
  
  
  METHODS
  University hospital.
  
  
  METHODS
  One hundred fifteen women who underwent laparoscopic myomectomy and 51 who underwent second-look minilaparoscopy.
  
  
  METHODS
  Laparoscopic myomectomy, in which fibrin glue spray was applied to prevent postoperative adhesion formation, and second-look laparoscopy.
  
  
  RESULTS
  The mean interval between surgeries was 5.1 +/- 3.0 months (range 2-18 mo). The mean size of enucleated myomas was 6.1 +/- 1.5 cm (range 3.0-10.5 cm), and mean number of myomas removed/patient was 3.0 +/- 2.2 (range 1-9 myomas). At assessment of 152 myomectomy sites, the rate of adhesions was 29.4%/patient and 11.2%/myomectomy site. Risk factors that influenced adhesion formation were posterior location and intramural myoma. In most cases the organ adhered to the myomectomy site was sigmoid colon. The frequency of adnexal adhesions was 17.6%/patient and 9.8%/site.
  
  
  CONCLUSIONS
  The rate of adhesion formation after laparoscopic myomectomy was low, and routine second-look microlaparoscopy was useful to evaluate the efficacy of the first surgery.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takeuchi
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kinoshita
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects* / Q000379:methods*; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007889:Leiomyoma / Q000175:diagnosis / Q000601:surgery*; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D024162:Second-Look Surgery / Q000379:methods*; D018709:Statistics, Nonparametric; D000267:Tissue Adhesions / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000601:surgery*