Гинекология (Jul 2023)
Effectiveness of hyaluronic acid-based anti-adhesion gel for intraoperative prevention of postoperative adhesions in surgical correction of distal occlusion of the fallopian tubes: Prospective cohort study
Abstract
Aim. To evaluate the effectiveness of hyaluronic acid anti-adhesion gel in surgical correction of distal tubal occlusion in restoring natural fertility in patients with infertility. Materials and methods. A prospective cohort study was conducted. The main group (group 1) included 54 women; the comparison group (group 2) included 58 women with tuboperitoneal infertility due to distal occlusion of the fallopian tubes. In group 1 patients, at the final stage of endoscopic reconstructive plastic surgery on the surface of the fallopian tubes, anti-adhesion barrier Anti-adhesion was applied (5 mL per each operated fallopian tube). Primary outcomes (patency of the fallopian tubes after 3 months) and secondary outcomes (onset of uterine pregnancy during the first year) were assessed. Statistical results were processed using the IBM SPSS Statistics version 25.0 software package. Results. Within 3 months after surgical treatment, the patency of the fallopian tubes was reported in 32 (59.3%) group 1 patients and 24 (41.4%) group 2 patients (2=3.445; p=0.064). The rate of uterine pregnancy in group 1 during the first year after surgical treatment was significantly higher than in group 2: 21 (38.9%) and 12 (20.7%) women, respectively (2=4.447; p=0.035). Conclusion. Endoscopic reconstructive plastic surgeries using hyaluronic acid-based anti-adhesion gel in patients with distal tubal occlusion slightly reduces the frequency of postoperative reocclusions of the fallopian tubes within 3 months after surgical treatment and significantly increase the rate of uterine pregnancy during the year after surgery mainly due to patients with grade IIIIV of adhesive process in the pelvis.
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