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document
Adhesion-prevention effects of fibrin sealants after laparoscopic myomectomy 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 I ) 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 20/32 ( 62.5 % ) in the control group , 10/29 ( 34.5 % ) in the fibrin gel group and 20/30 ( 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 4/32 patients ( 12.5 % ) in the control group , 2/29 patients ( 6.8 % ) in the fibrin gel group and 5/30 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 > or = 5 cm , postoperative adhesions were observed in > or = 50 % of patients . The use of fibrin gel after LM is recommended .
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Intervention_Pharmacological
fibrin sealants
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Intervention_Surgical
laparoscopic myomectomy
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Intervention_Surgical
fibrin sealant after laparoscopic myomectomy ( LM )
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Intervention_Surgical
LM
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Intervention_Pharmacological
fibrin gel
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Intervention_Physical
fibrin sheet group
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Intervention_Physical
postoperative adhesions
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Intervention_Pharmacological
fibrin gel
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Intervention_Pharmacological
fibrin gel
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Intervention_Pharmacological
fibrin sheet
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Intervention_Pharmacological
fibrin gel
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Intervention_Pharmacological
fibrin gel
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Intervention_Pharmacological
fibrin gel
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Outcome_Physical
Adhesion-prevention effects
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Outcome_Physical
adhesion prevention effects
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Outcome_Physical
postoperative adhesions
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Outcome_Other
second-look laparoscopy
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Outcome_Physical
frequency of postoperative adhesions
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Outcome_Physical
frequency of postoperative adhesions of the uterus
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Outcome_Physical
incidence of de novo adnexal adhesions
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Outcome_Physical
No bilateral adnexal adhesions
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Outcome_Physical
postoperative adhesions