Abstract Icodextrin (Adept®) has been shown to prevent postoperative adhesions in experimental and laparoscopic adhesiolysis surgery. However, the role of icodextrin in the prevention of adhesions in extensive gynecological surgery is unclear. The present study evaluated the effect of icodextrin on adhesion-related readmissions after extensive gynecologi-cal surgery. The hospital readmissions of 140 endometriosis patients operated on at Päijät-Häme Central Hospital in 2004– 2008with the use of icodextrinwere retrospectively reviewed. The evaluation of readmissions focused on adhesion-related disorders and reoperations. If an abdominal or pelvic reoper-ation was performed, the extent of the adhesions was classi-fied. The mean follow-up time was 6.53 years (range 0.21– 9.83). After initial surgery, one patient (0.7 %) had adhesive
small bowel obstruction. Another directly adhesion-related readmission occurred in two patients (1.4 %). The number of readmissions possibly related to adhesions was 3 (2.1 %). Abdominal or pelvic reoperation was performed on 54 pa-tients (38.6 %): 4 in the open surgery group and 50 in the laparoscopic surgery group. The extent of the adhesions
among the 54 reoperated patients was as follows: not men-tioned in 16 patients, no adhesions in 14, mild in 18, moderate in 5, and severe in 1. There were two (3.7 %) bowel injuries (one enterotomy and one serosal lesion) in reoperations. Th incidence of adhesion-related readmissions after the use of icodextrin is relatively low. This favorable resultmay be partly related to the laparoscopic technique. Despite the use of an anti-adhesion agent, in some patients, the extent of postoper-ative adhesions is severe.