Hyaluronic acid in the prevention of adhesions after gynecological surgery: systematic review and meta-analysis

Abstract

The purpose of this systematic review and meta-analysis was to evaluate the effect of hyaluronic acid on preventing adhesions after gynecological surgery. The search was conducted in electronic databases including PubMed, The Cochrane Library, ClinicalTrials.gov, Scopus, Embase, and Google Scholar. Clinical trials that reported original data concerning the evaluation of the effect of hyaluronic acid in the prevention of adhesions after gynecological surgery in women of reproductive age were included. 12 studies were included for qualitative analysis. We have conducted two meta-analyses: postoperative incidence of moderate or severe adhesions was significantly higher in the control group compared to the group that received hyaluronic acid gel (p = 0.0010); moreover, the proportion of sites with adhesions was statistically significantly higher in the control group compared to the experimental group (p < 0.00001). According to our results, hyaluronan gel application reduces the postoperative incidence of moderate or severe adhesions and the proportion of sites with adhesions in patients suffering from different gynecological diseases. Therefore, our data could popularize the usage of hyaluronic acid for the prevention of adhesions and encourage investigators to further develop antiadhesive barriers based on this molecule.