Kim T, Ahn KH, Choi DS, Hwang KJ, Lee BI, Jung MH, Kim JW, Kim JH, Cha SH, Lee KH, Lee KS, Oh ST, Cho CH, Rhee JH. A randomized, multi-center, clinical trial to assess the efficacy and safety of alginate carboxymethylcellulose hyaluronic acid compared to carboxymethylcellulose hyaluronic acid to prevent postoperative intrauterine adhesion.
J Minim Invasive Gynecol 2013;
19:731-6. [PMID:
23084677 DOI:
10.1016/j.jmig.2012.08.003]
[Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 08/01/2012] [Accepted: 08/02/2012] [Indexed: 10/27/2022]
Abstract
STUDY OBJECTIVE
To estimate the efficacy of alginate carboxymethylcellulose hyaluronic acid (ACH) gel to prevent intrauterine adhesions after hysteroscopic surgery in comparison with carboxymethylcellulose hyaluronic acid (CH) gel, which is known as an effective adhesion inhibitor.
DESIGN
Randomized, multicenter, single-blind, clinical trial (Canadian Task Force classification I).
SETTING
Tertiary university hospital.
PATIENTS
One hundred eighty-seven patients with a surgically treatable intrauterine lesion (myomas, polyps, septa, intrauterine adhesion, dysfunctional uterine bleeding).
INTERVENTIONS
Patients were randomized to 2 groups: hysteroscopic surgery plus intrauterine application of ACH or CH.
MEASUREMENTS AND RESULTS
The rate of adhesion formation and the adhesion severity score with type and extent were calculated 4 weeks after surgery. The ACH group had results that were comparable to the CH group in terms of the development of intrauterine adhesions at 4 weeks follow-up. The adhesion severities were not different between the 2 groups. In a subgroup without baseline intrauterine adhesion, the ACH group showed a lower intrauterine adhesion rate than the CH group (p = .016).
CONCLUSIONS
ACH had a comparable efficacy to CH in terms of the adhesion rate and severity. In the case of no baseline intrauterine adhesion, intrauterine application of ACH after hysteroscopic surgery had a lower rate of intrauterine adhesion than application of CH.
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