Adhesion-prevention effects of fibrin sealants after laparoscopic myornectomy as determined by second-look laparoscopy - A prospective, randomized, controlled study

OBJECTIVE: To examine the adhesion prevention effects of 2 types of fibrin sealant after laparoscopic myomectomy (LM). STUDY DESIGN: A prospective, randomized study (Canadian Task Force 1) was conducted at a University-affiliated hospital. A total of 91 patients showing a minimal myoma > 5 cm, excluding pedunculated myomas, underwent LM alone: 32 patients in the control group, 29 in the fibrin gel group and 30 patients in the fibrin sheet. group. After LM, postoperative adhesions were evaluated by second-look laparoscopy. The frequency of postoperative adhesions was the main. outcome. RESULTS: The frequency of postoperative adhesions of the uterus was significantly lower (p < 0.05) in the fibrin gel group, with 20132 (62.5%) in the control group, 10129 (34.5%) in the fibrin gel group and 20130 (67.7%) in the fibrin sheet group. Although no significant differences were found in the incidence of de novo adnexal adhesions, the lowest rate was found in the fibrin gel group, with 4132 patients (12.5%) in the control group, 2129 patients (6.8%) in the fibrin gel group and 5130 patients (16.7%) in the fibrin sheet group. No bilateral adnexal adhesions were observed in the 3 groups. CONCLUSION: After LM for myomas as large as >= 5 cm, postoperative adhesions were observed in >= 50% of patients. The use of fibrin gel after LM is recommended.