熊切　順
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Association between uterine repair at laparoscopic myomectomy and postoperative adhesions.
Journal Formal name：Acta obstetricia et gynecologica Scandinavica
Abbreviation：Acta Obstet Gynecol Scand
ISSN code：16000412/00016349
Domestic / ForeginForegin
Volume, Issue, Page 91(3),pp.331-7
Author and coauthor Kumakiri Jun†*, Kikuchi Iwaho, Kitade Mari, Matsuoka Shozo, Kono Ayako, Ozaki Rie, Takeda Satoru
Authorship Lead author,Corresponding author
Publication date 2012/03
Summary OBJECTIVE:To determine whether uterine repair at laparoscopic myomectomy influences postoperative adhesions.DESIGN:Retrospective study.SETTING:University-affiliated hospital.POPULATION:A total of 108 patients who underwent second-look laparoscopy after laparoscopic myomectomy without concomitant pelvic surgery between January 2006 and May 2010.METHODS:Absorbable cellulose adhesion barriers were used for uterine repair at initial surgery in all women. The presence of adhesions was evaluated by second-look laparoscopy.MAIN OUTCOME MEASURES:The influence of background factors (diameter of largest myoma, number of myomas, incision sites and number of suture layers) and the uterine status immediately after uterine repair at laparoscopic myomectomy (number, length and location of wounds, as well as wound appearance classified as virtually normal, swollen or protruding) on adhesion formation were analysed in 108 women with 296 uterine wounds. Data were analysed by logistic regression analysis.RESULTS:Forty-one (38.0%) women had adhesions to their uterus at follow up. We identified 48 (16.2%) adhesions among 296 wounds in all women. A protruding wound was significantly associated with postoperative wound adhesion (odds ratio, 2.53; p=0.02). The number of enucleated subserosal myomas (odds ratio, 3.29; p<0.001) and the diameter of the largest myoma (odds ratio, 1.05; p<0.001) were significantly associated with wound protrusion, which was a critical factor influencing adhesion.CONCLUSIONS:Postoperative wound adhesion formation seems to depend on uterine status immediately after laparoscopic myomectomy.
DOI 10.1111/j.1600-0412.2011.01339.x
PMID 22168781