Effectiveness of autocrosslinked hyaluronic acid gel after laparoscopic myomectomy in infertile patients: a prospective, randomized, controlled study.
OBJECTIVE
To assess the efficacy of autocrosslinked hyaluronic gel in postsurgical adhesion prevention after laparoscopic myomectomy.


METHODS
Prospective, randomized, controlled study.


METHODS
University of Naples "Federico II".Thirty-six infertile women with symptomatic myomas were randomly divided into two groups of 18 patients each.


METHODS
Laparoscopic myomectomy with subserous sutures or interrupted figure 8 sutures, with (group A) or without (group B) application of autocrosslinked hyaluronic acid (HA) gel.


METHODS
Rate of postsurgical adhesions at 60-90 days of follow-up. The rate of subjects who developed postoperative adhesions was significantly lower in group A in comparison with group B (27.8% vs. 77.8%). In both groups, the rate of adhesions was significantly higher in patients treated with interrupted figure 8 sutures than with subserous sutures.


CONCLUSIONS
Autocrosslinked HA gel is a promising resorbable agent barrier for the reduction of postoperative adhesions after laparoscopic myomectomy. Moreover, the type of suture is a factor influencing the postsurgical adhesion formation.
Pellicano
Massimiliano
M
Department of Obstetrics and Gynecology, University of Naples "Federico II", Naples, Italy. pellican@unina.it
Bramante
Silvia
S
Cirillo
Domenico
D
Palomba
Stefano
S
Bifulco
Giuseppe
G
Zullo
Fulvio
F
Nappi
Carmine
C
D000328:Adult; D005260:Female; D005782:Gels; D013509:Gynecologic Surgical Procedures; D006801:Humans; D006820:Hyaluronic Acid / Q000737:chemistry / Q000627:therapeutic use*; D015994:Incidence; D007247:Infertility, Female / Q000209:etiology*; D010535:Laparoscopy; D007889:Leiomyoma / Q000150:complications / Q000601:surgery*; D011182:Postoperative Care; D013536:Suture Techniques; D000267:Tissue Adhesions / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000150:complications / Q000601:surgery*
D005782:Gels; D006820:Hyaluronic Acid