Efficacy of Intraoperative Adhesion Barrier Use in Laparoscopic Surgery for Endometriosis: A Single-Center Retrospective Study on Long-Term Recurrence and Pelvic Pain

Objective: To evaluate the efficacy of intraoperative adhesion barriers in reducing long-term recurrence and alleviating pelvic pain in patients with endometriosis following laparoscopic surgery. Methods: A retrospective analysis was performed on 1246 patients with endometriosis who underwent laparoscopic surgery at Jingzhou Central Hospital from January 2019 to December 2023. Based on the application of adhesion barriers, these patients were categorized into a barrier group (n=628) and a control group (n=618). Clinical data, along with follow-up data on recurrence and pelvic pain, were collected. The Kaplan-Meier method, Visual Analogue Scale (VAS), and multivariate Cox regression analysis were employed for statistical evaluation. Results: The baseline characteristics between the two groups were comparable (both P> 0.05). The median follow-up duration was 36 months. The recurrence rate in the barrier group (15.29%) was significantly lower than that in the control group (26.38%, P< 0.001). Additionally, the VAS scores in the barrier group were consistently lower across all follow-up time points (all P< 0.05). The absence of adhesion barrier use, r-AFS stages III–IV, and incomplete lesion resection were identified as independent risk factors for recurrence. No significant adverse reactions were observed. Conclusion: Intraoperative adhesion barriers can effectively reduce long-term recurrence and safely alleviate pelvic pain. However, the study’s limitations, including its single-center retrospective design, necessitate further validation through large-scale, multicenter prospective studies. Keywords: endometriosis, laparoscopic surgery, adhesion barrier, long-term recurrence, pelvic pain, retrospective study