Reduction of Adhesions with Fibrin Glue after Laparoscopic Excision of Large Ovarian Endometriomas

Takeuchi H, Hiroyuki Takeuchi, H Takeuchi, M Awaji, Awaji M, Masanori Awaji, Hashimoto M, Masanori Hashimoto, M Hashimoto, Yoshihiro Nakano, Nakano Y, Y Nakano, Mitsuhashi N, Naoki Mitsuhashi, N Mitsuhashi, Y Kuwabara, Kuwabara Y, Yoshinori Kuwabara
The Journal of the American Association of Gynecologic Laparoscopists · 1996 · vol. 3(4) , pp. 575–579 · doi:10.1016/s1074-3804(96)80033-8 · PMID:9050691 · W2047747962
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Fibrin glue significantly reduced postoperative adhesions following laparoscopic endometrioma resection, particularly in cases involving larger cysts and pre-existing adhesions.

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Abstract

Study objectiveTo evaluate the effect of fibrin glue on the formation of adhesions after laparoscopic excision of endometriomas.DesignProspective case series.SettingDepartment of Obstetrics and Gynecology at a university-affiliated hospital.PatientsThirty women with ovarian cysts.InterventionsIn 10 women (16 cysts) we performed laparoscopic resection of endometriomas leaving the ovarian capsule open. Twenty patients (25 cysts) underwent laparoscopic removal of endometriomas and fibrin glue approximation of the ovarian capsule, as well as coating of serosal defects with the glue. At second-look laparoscopy 4 to 6 months after the initial surgery, postoperative adhesion formation was assessed according to the revised American Fertility Society classification.Measurements and main resultsThe mean (+/- SEM) adnexal adhesion score in patients without fibrin glue was 8.6 +/- 2.2 at initial surgery and increased slightly to 12.6 +/- 2.6 at second-look laparoscopy. In patients treated with fibrin glue, the score decreased significantly from 10.9 +/- 1.4 to 7.8 +/- 1.3 (p <0.02). The decrease was most marked in women with endometriomas 5 cm or more in diameter and for those with a preoperative adhesion score of 8 or higher.ConclusionFibrin glue reduced postoperative adhesions after laparoscopic resection of endometriomas.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Fibrin Tissue Adhesive Laparoscopy Ovarian Diseases Endometriosis Female Fibrin Tissue Adhesive Humans Laparoscopy Laparoscopy Ovarian Cysts Ovarian Cysts Ovarian Diseases Prospective Studies Tissue Adhesions Tissue Adhesions Tissue Adhesions

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