Efficacy of Intraoperative Adhesion Barrier Use in Laparoscopic Surgery for Endometriosis: A Single-Center Retrospective Study on Long-Term Recurrence and Pelvic Pain

Hu Y, Chen Y, Li G, Zou Q, Zhan J, Li D
In: International Journal of Women's Health, Vol Volume 18, Iss Issue 1, Pp 1-9 (2026) · 2026 · W7160973325
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Intraoperative adhesion barriers significantly reduced endometriosis recurrence and pelvic pain in a retrospective study of 1246 patients undergoing laparoscopic surgery.

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This single-center retrospective study analyzed 1,246 patients with endometriosis who underwent laparoscopic surgery from 2019–2023, comparing an intraoperative adhesion barrier group (n=628) with a control group (n=618) using follow-up data on long-term recurrence and pelvic pain assessed by VAS. Median follow-up was 36 months, and baseline characteristics were reported as comparable between groups. Recurrence was lower in the barrier group (15.29% vs 26.38%, P<0.001), and VAS pelvic pain scores were consistently lower at all follow-up time points (all P<0.05); multivariate Cox regression identified omission of adhesion barriers, r-AFS stages III–IV, and incomplete lesion resection as independent recurrence risk factors. The authors caution that, as a single-center retrospective design, results require confirmation in large-scale multicenter prospective studies. This paper is centrally about endometriosis — it evaluates whether intraoperative adhesion barrier use during laparoscopic surgery reduces long-term recurrence and pelvic pain in endometriosis.

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Abstract

Yao Hu,1,&ast; Yan Chen,1,&ast; Gaolian Li,1 Qingjing Zou,1 Jiawei Zhan,2 Dongmei Li3 1Department of Obstetrics and Gynecology, Jingzhou Central Hospital, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, People’s Republic of China; 2Gynecology Department, Xiaonan District Second People’s Hospital, Xiaogan, Hubei, People’s Republic of China; 3Department of Obstetrics and Gynecology, Songzi Traditional Chinese Medicine Hospital, Songzi, Hubei, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Dongmei Li, Email [email protected]: To evaluate the efficacy of intraoperative adhesion barriers in reducing long-term recurrence and alleviating pelvic pain in patients with endometriosis following laparoscopic surgery.Methods: A retrospective analysis was performed on 1246 patients with endometriosis who underwent laparoscopic surgery at Jingzhou Central Hospital from January 2019 to December 2023. Based on the application of adhesion barriers, these patients were categorized into a barrier group (n=628) and a control group (n=618). Clinical data, along with follow-up data on recurrence and pelvic pain, were collected. The Kaplan-Meier method, Visual Analogue Scale (VAS), and multivariate Cox regression analysis were employed for statistical evaluation.Results: The baseline characteristics between the two groups were comparable (both P> 0.05). The median follow-up duration was 36 months. The recurrence rate in the barrier group (15.29%) was significantly lower than that in the control group (26.38%, P< 0.001). Additionally, the VAS scores in the barrier group were consistently lower across all follow-up time points (all P< 0.05). The absence of adhesion barrier use, r-AFS stages III–IV, and incomplete lesion resection were identified as independent risk factors for recurrence. No significant adverse reactions were observed.Conclusion: Intraoperative adhesion barriers can effectively reduce long-term recurrence and safely alleviate pelvic pain. However, the study’s limitations, including its single-center retrospective design, necessitate further validation through large-scale, multicenter prospective studies.Keywords: endometriosis, laparoscopic surgery, adhesion barrier, long-term recurrence, pelvic pain, retrospective study
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International Journal of Women's Health (May 2026) Efficacy of Intraoperative Adhesion Barrier Use in Laparoscopic Surgery for Endometriosis: A Single-Center Retrospective Study on Long-Term Recurrence and Pelvic Pain Abstract Yao Hu,1,* Yan Chen,1,* Gaolian Li,1 Qingjing Zou,1 Jiawei Zhan,2 Dongmei Li3 1Department of Obstetrics and Gynecology, Jingzhou Central Hospital, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, People’s Republic of China; 2Gynecology Department, Xiaonan District Second People’s Hospital, Xiaogan, Hubei, People’s Republic of China; 3Department of Obstetrics and Gynecology, Songzi Traditional Chinese Medicine Hospital, Songzi, Hubei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Dongmei Li, Email [email protected]: To evaluate the efficacy of intraoperative adhesion barriers in reducing long-term recurrence and alleviating pelvic pain in patients with endometriosis following laparoscopic surgery.Methods: A retrospective analysis was performed on 1246 patients with endometriosis who underwent laparoscopic surgery at Jingzhou Central Hospital from January 2019 to December 2023. Based on the application of adhesion barriers, these patients were categorized into a barrier group (n=628) and a control group (n=618). Clinical data, along with follow-up data on recurrence and pelvic pain, were collected. The Kaplan-Meier method, Visual Analogue Scale (VAS), and multivariate Cox regression analysis were employed for statistical evaluation.Results: The baseline characteristics between the two groups were comparable (both P> 0.05). The median follow-up duration was 36 months. The recurrence rate in the barrier group (15.29%) was significantly lower than that in the control group (26.38%, P< 0.001). Additionally, the VAS scores in the barrier group were consistently lower across all follow-up time points (all P< 0.05). The absence of adhesion barrier use, r-AFS stages III–IV, and incomplete lesion resection were identified as independent risk factors for recurrence. No significant adverse reactions were observed.Conclusion: Intraoperative adhesion barriers can effectively reduce long-term recurrence and safely alleviate pelvic pain. However, the study’s limitations, including its single-center retrospective design, necessitate further validation through large-scale, multicenter prospective studies.Keywords: endometriosis, laparoscopic surgery, adhesion barrier, long-term recurrence, pelvic pain, retrospective study

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