[Clinical value of anti-adhesion agents used in laparotomy in obstetrics and gynecology]

Abstract

Objective: To investigate clinical value of anti-adhesion agent:chitosan in preventing adhesions followed by laparotomy surgery in obstetrics and gynecology.

Methods: From Jan. 2006 to Dec. 2009, 770 patients underwent laparotomy surgery at Department of Obstetrics and Gynecology in the Second Affiliated Hospital of Harbin Medical University. One hundred and twenty-five patients underwent secondary surgery due to disease recurrence or cesarean section, the previous surgery were 18 cases with myomectomy, 20 cases with endometriosis surgery, 5 cases with resection of pelvic abscess, 20 cases with ectopic pregnancy surgery, 27 cases with benign adnexal neoplasm resection, 9 cases with cyto-reductive surgery in ovarian cancer, 26 cases with variable infertility surgery. Those 125 patients were managed by different agents washing before abdomen closure, which were assigned into two groups, including 59 cases washed by saline in control group and 66 cases washed by chitosan in study group. The abdomen adhesion in secondary surgery was evaluated by adhesion classification system.

Results: In study group, 37 patients without adhesions, 20 patients with degree I adhesion, 6 patients with degree II adhesion, 3 patients with degree III adhesion, and no patients with degree IV adhesion were observed. While in control group, there were 11 patients without adhesions, 23 patients with degree I adhesion, 14 patients with degree II adhesion, 8 patients with degree III adhesion, and 3 patients with degree IV adhesion. The distribution of adhesion reached statistical significance between the two groups (χ(2) = 20.9999, P = 0.0003). Twenty-six patients in previous surgeries due to infertility included 17 cases in control group and 9 cases in study group. They all were managed by cesarean section in secondary surgery, it was found that 15 cases without adhesion and 2 cases with degree I adhesion were in study group and 2 cases without adhesion and 7 cases with degree I adhesion were in control group. It reached statistical difference (P = 0.0016).

Conclusion: Anti-adhesion agent could prevent adhesion followed by surgery in obstetrics and gynecology effectively.