Volume 12, Issue 1 (2-2026)
Caspian J Reprod Med 2026, 12(1): 24-33 |
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Ataei M, Shadjo K, Mahmoudzadeh S, Sehat Z. Effect of InterGuard on postoperative adhesion formation following laparoscopic surgery for advanced endometriosis: A double-blind randomized controlled trial. Caspian J Reprod Med 2026; 12 (1) :24-33
URL: http://caspjrm.ir/article-1-298-en.html
URL: http://caspjrm.ir/article-1-298-en.html
Reproductive Biotechnology Research Centre, Avicenna Research Institute (ARI), Academic Centre for Education, Culture and Research (ACECR), Tehran, Iran , drshadjoo@gmail.com
Abstract: (10 Views)
Background: Postoperative adhesions are a common complication following laparoscopic surgery for advanced endometriosis and may increase surgical complexity and impair reproductive function. Evidence regarding the effectiveness of adhesion prevention barriers in laparoscopic endometriosis surgery remains limited. This randomized controlled trial evaluated the effectiveness of InterGuard, an oxidized regenerated cellulose adhesion barrier, in reducing postoperative adhesion formation.
Methods: In this double-blind randomized controlled trial, 50 women undergoing laparoscopic surgery for stage III-IV endometriosis were randomly assigned to receive either InterGuard (n = 25) or saline irrigation (n = 25) following adhesiolysis. The primary outcome was the total postoperative adhesion score assessed three months after surgery using a standardized transvaginal ultrasonographic scoring system based on adhesion extent and severity. Analysis of covariance (ANCOVA) was performed to examine the influence of prespecified baseline variables on postoperative adhesion scores.
Results: All 50 randomized participants completed the study. Baseline demographic and clinical characteristics were comparable between groups. At three months, the mean postoperative adhesion score was significantly lower in the InterGuard group than in the control group (2.37 ± 0.29 vs. 6.59 ± 1.58; P < 0.001). After adjustment for baseline characteristics, previous abdominal surgery was the only variable significantly associated with postoperative adhesion score (partial η² = 0.164, P = 0.012).
Conclusion: InterGuard was associated with significantly lower postoperative ultrasonographic adhesion scores following laparoscopic surgery for advanced endometriosis. Given the small sample size, the use of ultrasonography rather than second-look laparoscopy, and the lack of long-term clinical outcomes, larger multicenter randomized trials are needed to confirm these findings and establish their clinical relevance.
Methods: In this double-blind randomized controlled trial, 50 women undergoing laparoscopic surgery for stage III-IV endometriosis were randomly assigned to receive either InterGuard (n = 25) or saline irrigation (n = 25) following adhesiolysis. The primary outcome was the total postoperative adhesion score assessed three months after surgery using a standardized transvaginal ultrasonographic scoring system based on adhesion extent and severity. Analysis of covariance (ANCOVA) was performed to examine the influence of prespecified baseline variables on postoperative adhesion scores.
Results: All 50 randomized participants completed the study. Baseline demographic and clinical characteristics were comparable between groups. At three months, the mean postoperative adhesion score was significantly lower in the InterGuard group than in the control group (2.37 ± 0.29 vs. 6.59 ± 1.58; P < 0.001). After adjustment for baseline characteristics, previous abdominal surgery was the only variable significantly associated with postoperative adhesion score (partial η² = 0.164, P = 0.012).
Conclusion: InterGuard was associated with significantly lower postoperative ultrasonographic adhesion scores following laparoscopic surgery for advanced endometriosis. Given the small sample size, the use of ultrasonography rather than second-look laparoscopy, and the lack of long-term clinical outcomes, larger multicenter randomized trials are needed to confirm these findings and establish their clinical relevance.
Keywords: Endometriosis, Laparoscopy, Postoperative adhesions, Oxidized regenerated cellulose, InterGuard, Randomized controlled trial
Type of Study: Original Research |
Subject:
Reproductive endocrinology
Received: 2026/05/15 | Accepted: 2026/06/25 | Published: 2026/06/28
Received: 2026/05/15 | Accepted: 2026/06/25 | Published: 2026/06/28
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