Cochrane · systematic review · CD000475

Barrier agents for adhesion prevention after gynaecological surgery

Ahmad, G, Kim, K, Thompson, M, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library

Gynaecology and Fertility2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
24
current version
GRADE rated
10
No studies
14
Included studies
NR
No studies 14 · 58.3%Ungraded 0 · 0%Very low 8 · 33.3%Low 2 · 8.3%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 2 versions

Analysis 1 ‐ Oxidised regenerated cellulose vs no treatment at laparoscopy for adhesion prevention after gynaecological surgery

Population: women having gynaecological surgery
6 questions
OutcomeEffectEvidenceStatus / GRADE
Pelvic pain
Analysis 1 ‐ Oxidised regenerated cellulose vs no treatment at laparoscopy
no estimate extractedNRNo studies
Live birth rate
Analysis 1 ‐ Oxidised regenerated cellulose vs no treatment at laparoscopy
no estimate extractedNRNo studies
Adhesion score
Analysis 1 ‐ Oxidised regenerated cellulose vs no treatment at laparoscopy
no estimate extractedNRNo studies
Incidence of adhesions ‐ de novo Incidence of adhesions at second‐look laparoscopy
Analysis 1 ‐ Oxidised regenerated cellulose vs no treatment at laparoscopy
OR 0.5 [0.3, 0.83]3 studies · 360 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency, publication bias
Incidence of adhesions ‐ re‐formation (or mixture) Incidence of adhesions at second‐look laparoscopy
Analysis 1 ‐ Oxidised regenerated cellulose vs no treatment at laparoscopy
OR 0.17 [0.07, 0.41]3 studies · 100 participantsVery low
Downgraded: risk of bias, imprecision, publication bias
Clinical pregnancy rate
Analysis 1 ‐ Oxidised regenerated cellulose vs no treatment at laparoscopy
no estimate extractedNRNo studies

Analysis 2 ‐ Oxidised regenerated cellulose vs no treatment at laparotomy for adhesion prevention after gynaecological surgery

Population: women having gynaecological surgery
6 questions
OutcomeEffectEvidenceStatus / GRADE
Pelvic pain
Analysis 2 ‐ Oxidised regenerated cellulose vs no treatment at laparotomy
no estimate extractedNRNo studies
Live birth rate
Analysis 2 ‐ Oxidised regenerated cellulose vs no treatment at laparotomy
no estimate extractedNRNo studies
Adhesion score
Analysis 2 ‐ Oxidised regenerated cellulose vs no treatment at laparotomy
no estimate extractedNRNo studies
Incidence of adhesions ‐ de novo Incidence at second‐look laparoscopy
Analysis 2 ‐ Oxidised regenerated cellulose vs no treatment at laparotomy
OR 0.72 [0.42, 1.25]1 study · 271 participantsVery low
Downgraded: risk of bias, imprecision, publication bias
Incidence of adhesions ‐ re‐formation (or mixture) Incidence at second‐look laparoscopy
Analysis 2 ‐ Oxidised regenerated cellulose vs no treatment at laparotomy
OR 0.38 [0.27, 0.55]6 studies · 554 participantsLow
Downgraded: risk of bias, inconsistency, publication bias
Clinical pregnancy rate
Analysis 2 ‐ Oxidised regenerated cellulose vs no treatment at laparotomy
no estimate extractedNRNo studies

Analysis 4 ‐ Expanded polytetrafluoroethylene vs oxidised regenerated cellulose for adhesion prevention after gynaecological surgery

Population: women having gynaecological surgery
6 questions
OutcomeEffectEvidenceStatus / GRADE
Pelvic pain
Analysis 4 ‐ Expanded polytetrafluoroethylene vs oxidised regenerated cellulose
no estimate extractedNRNo studies
Live birth rate
Analysis 4 ‐ Expanded polytetrafluoroethylene vs oxidised regenerated cellulose
no estimate extractedNRNo studies
Adhesion score Non‐validated score out of 11 at SLL
Analysis 4 ‐ Expanded polytetrafluoroethylene vs oxidised regenerated cellulose
no estimate extracted1 study · 58 participantsVery low
Downgraded: risk of bias, imprecision, publication bias
Incidence of adhesions ‐ de novo Incidence at second‐look laparoscopy
Analysis 4 ‐ Expanded polytetrafluoroethylene vs oxidised regenerated cellulose
OR 0.93 [0.26, 3.41]1 study · 38 participantsVery low
Downgraded: risk of bias, imprecision, publication bias
Incidence of adhesions ‐ re‐formation (or mixture) Incidence at second‐look laparoscopy
Analysis 4 ‐ Expanded polytetrafluoroethylene vs oxidised regenerated cellulose
OR 0.13 [0.02, 0.8]1 study · 23 participantsVery low
Downgraded: risk of bias, imprecision, publication bias
Clinical pregnancy rate
Analysis 4 ‐ Expanded polytetrafluoroethylene vs oxidised regenerated cellulose
no estimate extractedNRNo studies

Analysis 7 ‐ Collagen membrane with polyethylene glycol and glycerol vs Ringer's lactate

Population: patients with adhesion prevention after gynaecological surgery
6 questions
OutcomeEffectEvidenceStatus / GRADE
Pelvic pain
Analysis 7 ‐ Collagen membrane with polyethylene glycol and glycerol vs Ringer's lactate
no estimate extractedNRNo studies
Live birth rate
Analysis 7 ‐ Collagen membrane with polyethylene glycol and glycerol vs Ringer's lactate
no estimate extractedNRNo studies
Adhesion score
Analysis 7 ‐ Collagen membrane with polyethylene glycol and glycerol vs Ringer's lactate
no estimate extracted1 study · 47 participantsVery low
Downgraded: risk of bias, imprecision, publication bias
Incidence of adhesions ‐ de novo Incidence at second‐look laparoscopy
Analysis 7 ‐ Collagen membrane with polyethylene glycol and glycerol vs Ringer's lactate
OR 0.04 [0, 0.77]1 study · 47 participantsLow
Downgraded: risk of bias, imprecision, publication bias
Incidence of adhesions ‐ re‐formation or mixture Incidence at second‐look laparoscopy
Analysis 7 ‐ Collagen membrane with polyethylene glycol and glycerol vs Ringer's lactate
no estimate extractedNRNo studies
Clinical pregnancy rate
Analysis 7 ‐ Collagen membrane with polyethylene glycol and glycerol vs Ringer's lactate
OR 5.69 [1.38, 23.48]1 study · 39 participantsVery low
Downgraded: risk of bias, imprecision, publication bias