title: Adhesion Barrier Use After Myomectomy and Hysterectomy: Rates and Immediate Postoperative Complications.
abstract: OBJECTIVE
  To evaluate use rates and immediate postoperative complications of the use of an adhesion barrier in myomectomy or hysterectomy.
  
  
  METHODS
  This was a retrospective cohort study. Using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample, we examined the records of women with primary discharge diagnosis of uterine myoma during the period 2003-2011. We evaluated use rates and complications among 473,788 women treated by myomectomy or hysterectomy.
  
  
  RESULTS
  Of 473,788 women treated by myomectomy or hysterectomy, adhesion barrier was used in 3,392 of 62,563 myomectomies (5.4%) and 5,590 of 411,225 hysterectomies (1.4%). The rate of ileus after myomectomy in the nonbarrier group (1,290/59,171 [2%]) was lower than in the barrier group (109/3,392 [3%]; adjusted odds ratio [OR] 1.50 [1.22-1.83]) and similar after hysterectomy (10,329/405,635 [2.5%] compared with 288/5,590 [5%]; adjusted OR 1.97 [1.75-2.23]). Postoperative fever was also higher in the adhesion barrier group after myomectomy (4.4% compared with 2.9%, adjusted OR 1.44 [1.21-1.71]) as well as after hysterectomy (2.5% compared with 1.6%, OR 1.65 [1.40-1.96]). Small bowel obstruction after hysterectomy in the nonbarrier group (804/405,635 [0.2%]) was less frequent than in the barrier group (23/5,590 [0.4%]; OR 1.90 [1.25-2.89]), but not after myomectomy.
  
  
  CONCLUSIONS
  Although the use of adhesion barrier remains very low, the use is associated with a slightly higher incidence of fever and ileus after myomectomy and hysterectomy and with bowel obstruction after hysterectomy.
authors.affiliation: Department of Obstetrics and Gynecology, McGill University, and the Department of Epidemiology and Biostatistics, Jewish General Hospital, Montreal, Quebec, Canada.
authors.forename: Togas
authors.initials: T
authors.lastname: Tulandi
authors.forename: Francois
authors.initials: F
authors.lastname: Closon
authors.forename: Nicolas
authors.initials: N
authors.lastname: Czuzoj-Shulman
authors.forename: Haim
authors.initials: H
authors.lastname: Abenhaim
mesh_terms: D000328:Adult; D001672:Biocompatible Materials / Q000627:therapeutic use; D005260:Female; D005334:Fever / Q000453:epidemiology; D006406:Hematoma / Q000453:epidemiology; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D045823:Ileus / Q000453:epidemiology; D015994:Incidence; D008567:Membranes, Artificial; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology; D063186:Uterine Myomectomy / Q000009:adverse effects*
chemical_list: D001672:Biocompatible Materials; D008567:Membranes, Artificial