Utian, W. H., Goldfarb, J. M., & Starks, G. C. (1979). Role of dextran 70 in microtubal surgery. Fertility and Sterility, 31(1), 79-82. https://doi.org/10.1016/s0015-0282(16)43765-9
Utian WH, Goldfarb JM, Starks GC. Role of dextran 70 in microtubal surgery. Fertil Steril. 1979;31(1):79-82. doi:10.1016/s0015-0282(16)43765-9
Utian, Wulf H., et al. "Role of dextran 70 in microtubal surgery." Fertility and Sterility, vol. 31, no. 1, 1979, pp. 79-82.
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Dextran 70 after tubal repair increased pregnancy rates in rabbits
This randomized rabbit study tested fluids used during tubal surgery. More rabbits got pregnant after dextran 70 than after saline or no fluid. About 8 of 10 mated rabbits got pregnant with dextran 70. About 1 of 10 got pregnant with saline. About 5 of 10 got pregnant with no fluid.
Key Findings
Pregnancies among mated rabbits: 7 of 9 (77.8%) with dextran 70, 1 of 9 (11.1%) with saline and 4 of 8 (50.0%) with no fluid.
The pregnancy rate was significantly higher in both dextran-treated groups than in the saline and untreated groups (chi-square test, P < 0.025).
Severe adhesions occurred in 2 of 10 rabbits given dextran 70, 4 of 10 given saline and 7 of 10 given no fluid; the group difference was not statistically significant.
Adhesion scores were 24 of 60 (40.0%) with dextran 70, 29 of 60 (48.3%) with saline and 38 of 60 (63.3%) with no fluid.
Three of 7 rabbits given a much stronger dextran 70 solution died soon after surgery, and that group was stopped.
Interpretation
This randomized animal study used healthy virgin rabbits. Each rabbit had the same tubal repair. Rabbits were then assigned by chance to dextran 70, saline, or no fluid. A second surgery checked for scar tissue four weeks later. Mating showed which rabbits became pregnant. Dextran 70 led to less scar tissue and more pregnancies than saline or no fluid. The authors note that good surgical technique still matters most, and call dextran 70 a helpful addition to it. The findings support larger studies of this fluid in tubal surgery.
RRM Context
Restorative reproductive medicine works to repair the body so couples can conceive. Scar tissue is a common cause of failed tubal surgery. This study tested one way to reduce it.
Our editorial summary of this paper, not the article's abstract.
Abstract
Pelvic adhesion formation represents a major problem following fallopian tube surgery for infertility. Intraperitoneal dextran may prevent pelvic adhesions. Extensive personal clinical experience (W. H. U.) with intraperitoneal dextran organ-flotation on completion of tubal and ovarian surgery has appeared to limit adhesions. A specific study was designed to test the validity of this theory. Four randomized groups of rabbits were subjected to bilateral tubocornual division and microsurgical reanastomosis with total hemostasis and pelvic lavage. Routine peritoneal closure was performed on one group, but followed instillation of 30 to 50 ml of normal saline into the peritoneal cavities of the second group, and 30 to 50 ml of 6% dextran 70 into those of the third. Study of fourth group, which received 32% dextran 70 in the peritoneal cavity, was discontinued because of complications. A second laparotomy was performed 4 weeks later for precise assessment and photography of adhesion formation. Each animal was mated 4 weeks after the second operation in order to determine fertility rates. Reduced adhesion formation and increased fertility rates following the instillation of dextran are reported. A role for dextran 70 in infertility surgery is recommended.
