Reduction of postoperative pelvic adhesions with intraperitoneal 32% dextran 70: a prospective, randomized clinical trial

Fertility and sterility · 1983 · vol. 40(5) , pp. 612–619 · doi:10.1016/s0015-0282(16)47419-4 · PMID:6195021 · W2522078556
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This prospective, randomized clinical trial investigated the efficacy of intraperitoneal 32% dextran 70 in reducing postoperative pelvic adhesions.

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Abstract

Infertile women of reproductive age requiring an operation for distal tubal disease, endometriosis, or pelvic adhesions were recruited from nine study centers. Prior to closing the peritoneal cavity, 250 ml of 32% dextran 70 (n = 55) or saline (n = 47) was instilled into the dependent portion of the pelvis; 8 to 12 weeks later, laparoscopy was performed on those patients not pregnant. Patients with severe adnexal adhesions at the initial laparotomy had a greater reduction in adhesions if they received 32% dextran 70. Further, patients with a marked reduction in adhesion formation following the initial laparotomy were found to occur more frequently in the 32% dextran 70-treated group (26 of 51 for 32% dextran 70 versus 12 of 40 for saline; P less than 0.05). During second-look laparoscopy, adhesions were found to occur more frequently in control patients than in 32% dextran 70-treated patients at the following anatomic sites: ovary (P less than 0.05); cul-de-sac (P = 0.017); pelvic side wall (P less than 0.001). Thus, in a prospective, randomized, blinded clinical trial, the intraperitoneal high-molecular-weight dextran was found to reduce postoperative adhesion formation effectively.

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MeSH descriptors

Adnexal Diseases Dextrans Infertility, Female Laparotomy Adnexal Diseases Adnexal Diseases Adult Clinical Trials as Topic Dextrans Double-Blind Method Female Humans Infertility, Female Injections, Intraperitoneal Laparoscopy Laparotomy Pelvic Inflammatory Disease Pelvic Inflammatory Disease Postoperative Complications Postoperative Complications

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