High-molecular weight dextran in human infertility surgery

Area of Science:

• Reproductive Medicine
• Surgical Innovation
• Biomaterials in Surgery

Background:

• Surgical adhesions pose a significant risk following abdominal surgeries, particularly in infertility operations.
• High-molecular weight dextran 70 (HMWD70) has shown promise in reducing adhesions in animal models.
• The efficacy of HMWD70 in human infertility surgery requires further clinical validation.

Purpose of the Study:

• To evaluate the effectiveness of intraperitoneal 32% high-molecular weight dextran 70 in preventing surgical adhesions.
• To assess the impact of HMWD70 on adhesion reformation after lysis in women undergoing major abdominal infertility operations.

Main Methods:

• A prospective, randomized, double-blind study involving 44 women undergoing major abdominal infertility operations.
• Standardized objective criteria were used to quantify adhesions at initial surgery and reevaluated via second-look laparoscopy approximately 6 weeks later.
• Patients were randomized to receive either 32% dextran 70 or a control treatment.

Main Results:

• The 32% dextran 70 group showed a significant mean reduction in adhesion score (-2.57 units) compared to the control group's worsening score (+2.41 units) (p = 0.016).
• In patients undergoing lysis of adhesions, the dextran 70 group demonstrated significant improvement (-4.2 units) versus minimal change in the control group (+0.3 unit) (p < 0.05).
• HMWD70 was effective in both reducing initial adhesion formation and preventing reformation after surgical lysis.

Conclusions:

• Intraperitoneal 32% high-molecular weight dextran 70 is effective in reducing the incidence of surgical adhesions in women undergoing major abdominal infertility operations.
• HMWD70 significantly reduces adhesion reformation following lysis, offering a valuable tool for improving surgical outcomes in fertility procedures.