human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Laparoscopic Nd-YAG laser photocoagulation of the ovaries was performed in 40 anovulatory women with clomiphene citrate-resistant polycystic ovary disease . Following this procedure , the subjects were r and omly assigned to have either a second-look laparoscopy with lysis of adhesions within 3 - 4 weeks of the initial laparoscopy ( N=19 ) or expectant management ( N=20 ) . One patient assigned to the laparoscopy group refused the procedure . Minimal and mild adhesions that did not distort the normal tubo-ovarian relationship were encountered in 13 patients ( 68 % ) in the second-look laparoscopy group ; these adhesions were easily lysed using sharp or blunt dissection . The pregnancy rates over 6 months were similar in the two groups ( 47 % in the second-look group and 55 % in the expectant-management group ; P>.05 ) . These data suggest that early laparoscopic lysis of adhesions does not improve short-term conception rates following laparoscopic Nd-YAG laser photocoagulation of polycystic ovaries This study describes a prospect i ve r and omized controlled trial to evaluate whether suture of the peritoneal layer is necessary as a separate step in the closure of midline abdominal surgical wounds . Consecutive patients undergoing abdominal operation — elective and emergency surgery — through a midline abdominal wound were r and omized to have the peritoneal layer closed with continuous catgut , or to have this step omitted . The linea alba was closed with interrupted stainless steel sutures , and the skin approximated with staples . Patients were evaluated for wound sepsis , wound dehiscence , and subsequent incisional hernia development . Postoperative pain was assessed by a self-administered visual analogue score , and by measuring narcotic requirements . There was no significant difference in narcotic requirements , pain scores , or wound complications between the 2 groups . Single-layer closure of the abdominal wall is quicker , less costly , and theoretically safer than layered closure , and it is recommended that separate suture of the peritoneum be ab and oned . ResuméDans cette étude prospect i ve , r and omisée , et contrôlée , nous avons cherché à savoir si la fermeture individualisée du péritoine était nécessaire dans la fermeture d'une laparotomie médiane . Deux cents patients consécutifs — opérés à froid ou en urgence — par laparotomie médiane  , ont été r and omisés : dans un groupe , le péritoine a été fermé en un plan individualisé par un surjet au catgut , dans l'autre , le péritoine n'a pas été suturé . La ligne blanche a été fermée en un plan par des points séparés de fils d'acier ; la peau a été fermée par des agrafes . On a étudié le nombre des abcès de paroi , des éviscérations , et , à distance , des éventrations . La douleur postopératoire a été évaluée par un score analogue visuel , établi par le patient lui-même , ainsi que par la nécessité d'utiliser des antalgiques . Il n'y avait pas de différence significative entre les 2 groupes en ce qui concerne le taux de complications pariétales ou l'existence de douleur . Comme la fermeture pariétale en un seul plan est plus rapide , coûte moins cher , et , est théoriquement plus sûre ( on peut surveiller le contenu intrapéritonéal pendant la fermeture ) que la fermeture plan par plan , nous recomm and ons d'ab and oner la fermeture individualisée du péritoine . ResumenEl presente articulo describe un ensayo clínico prospect ivo destinado a investigar si es necesaria la sutura de la capa peritoneal como un paso independiente en el cierre de incisiones abdominales de línea media . Una serie de pacientes consecutivos sometidos a operaciones abdominales fueron r and omizados a cierre peritoneal con sutura continua de catgut  o a omisión de este paso . La línea alba fue cerrada con suturas interrumpidas de acero inoxidable y la piel con agrafes . Se estudió la incidencia de infección de herida , de dehiscencia , y de desarrollo de hernia incisional subsiguientes . La valoración del dolor postoperatorio fue realizada mediante autoevaluación con una escala linear análoga y la determinación de los requerimientos de narcóticos . No se encontraron diferencias significativas en el requerimiento de narcóticos para analgesia , en el nivel de la escala de dolor , o en la tasa de complicaciones entre los 2 grupos . El cierre de la pared abdominal en una capa única es más rápido , menos costoso , y teóricamente más seguro ; por lo tanto , se recomienda ab and onar la sutura del peritoneo OBJECTIVE To determine the effect of closure or non-closure of the visceral peritoneum at cesarean delivery on uterine scar formation assessed at repeat cesarean delivery . METHODS Women undergoing initial cesarean delivery were allocated into 2 groups : group 1 underwent visceral peritoneal closure , while in group 2 the visceral peritoneum was not closed . At repeat cesarean delivery 4 specimens from the initial uterine scar were collected and assessed by light microscopy and scanning electron microscopy . RESULTS In group 1 , 57 % of women had adhesions compared with 20.6 % in group 2 ( P<0.05 ) . Light microscopy revealed reactive mesothelial hyperplasia ( 51.8 % vs 13.7 % ) , submesothelial fibrosis ( 48.1 % vs 6.8 % ) , and neoangiogenesis of mesothelial stroma ( 44.4 % vs 12 % ) in group 1 and group 2 patients , respectively ( P<0.05 ) . Scanning electron microscopy showed more patients with pericytes on the surface of microvessels in group 1 compared with group 2 ( 26.3+/-1.4 vs 11.5+/-1.1 patients ; P<0.05 ) . CONCLUSION Closure of the visceral peritoneum at cesarean delivery may produce an inflammatory reaction and adhesions , evidence d by reactive and regenerative mesothelial hyperplasia and submesothelial fibrosis Objectives Laparoscopic ovarian drilling ( LOD ) has been put forward as the treatment of choice in women with clomiphene citrate (CC)-resistant polycystic ovary syndrome ( PCOS ) , with tubo-ovarian adhesion formation as the major disadvantage . Our study proposed to compare the efficacy of laparoscopic unilateral ovarian drilling with bilateral ovarian drilling in terms of ovulation and pregnancy rate with the expected advantage of decreasing postoperative adhesion rate and change in fimbiro ovarian relationship with unilateral drilling . Methods This prospect i ve r and omized study included 44 patients with anovulatory infertility due to PCOS . Twenty-two patients underwent unilateral ovarian drilling  in group-I and 22 patients underwent bilateral ovarian drilling in group-II between June 2005 and June 2007 . The number of drilling site in each ovary was limited to five . The clinical and biochemical response , ovulation and pregnancy rates over a follow-up period of 1 year were compared . Tubo-ovarian adhesion rate was compared during cesarean section or during repeat laparoscopy . Results There was no statistical difference between the two groups in terms of clinical and biochemical response , ovulation rate and pregnancy rate . Postoperatively , tubo-ovarian adhesions could be assessed in 36.3 % of the patients and no adhesions were found in a single case in either group . Conclusion Unilateral drilling cauterization of ovary is equally efficacious as bilateral drilling in inducing ovulation and achieving pregnancy .  Unilateral ovarian drilling may be a suitable option in clomiphene citrate resistant infertility patient of PCOS which can replace bilateral ovarian drilling with the potential advantage of decreasing the chances of adhesion formation BACKGROUND The purpose of this study was to analyze long-term recurrence rates and complications in patients previously enrolled in a prospect i ve r and omized trial comparing laparoscopic ( LC ) and open ileocolectomy ( OC ) for ileocolic Crohn 's disease ( CD ) . METHODS Follow-up data were available on 56 of 60 patients .  Demographic data , recurrence rates , need for additional surgery related to primary procedure , and medication use were recorded . RESULTS Mean follow-up for 56 patients ( 27 LC vs 29 OC ) was 10.5 years and comparable between LC and OC ( 10.0 vs 11.0 , respectively ; P = .64 ) . One patient died 8 years after OC of causes unrelated to CD . Eight patients for each group underwent initial reoperative ( 26 % LC vs 28 % OC ; P = .89 ) . One patient underwent incisional hernia repair  after LC ( 4 % ) versus 4 patients ( 14 % ) after OC ( P = .61 ) . Two patients in the LC group underwent  adhesiolysis  versus none after OC ( P = .23 ) . Incidences of anorectal disease , anorectal surgery , endoscopic or radiologic recurrence , and medication use were also similar between LC and OC . OC patients requiring operation during follow-up were significantly more likely than LC to require multiple operations ( P = .006 ) . CONCLUSIONS Long-term data from this prospect i ve r and omized trial confirm that LC is at least comparable to OC in the treatment of ileocolic CD OBJECTIVE To assess the rate of adhesions and other long-term outcomes of two cesarean delivery techniques . METHODS A total of 600 women were r and omly assigned to either a st and ard ( Pfannenstiel-Kerr ) or modified ( Joel-Cohen-Stark ) technique for first-time cesarean delivery . A total of 124 women were assessed at repeat cesarean delivery . The primary outcome measure was the presence of adhesions . RESULTS At repeat cesarean delivery , anesthesia-to-delivery time , total duration of surgery , change in hemoglobin level , time to mobilization and oral intake , and postoperative hospital stay were significantly less with the modified technique . Adhesions were found in 7 ( 11.3 % ) and 22 ( 35.5 % ) of the cases using the modified and st and ard techniques , respectively ( P=0.0026 ; relative risk 3.14 [ 95 % CI , 1.45 - 6.82 ] ) . CONCLUSION A modified cesarean delivery technique , including Joel-Cohen incision , exteriorized full thickness suturing of the uterine incision , and non-closure of the peritoneum may reduce long-term morbidities of the procedure OBJECTIVE To compare bipolar coagulation and suturing of the ovary in terms of postoperative ovarian adhesions after  laparoscopic ovarian cystectomy for endometriosis . DESIGN Prospect i ve , r and omized , controlled study . SETTING Department of Obstetrics and Gynecology , University of Naples " Federico II . " PATIENT(S ) Thirty-two women with a single endometriotic cyst were r and omly divided into two groups of 16 women each ( groups A and B ) . INTERVENTION(S ) All patients underwent laparoscopic ovarian cystectomy for endometriosis . In group A , hemostasis was performed by closure of the ovary with an intraovarian suture . In group B , complete hemostasis was achieved only with bipolar coagulation on the internal face of the ovary . MAIN OUTCOME MEASURE(S ) Rate and extension of postsurgical ovarian adhesions at 60 - 90 days follow-up . RESULT ( S ) At follow-up , a significantly lower rate of postsurgical ovarian adhesions was observed in group A than in group B ( 30.8 % vs. 57.1 % ) . The extension of ovarian adhesions was significantly higher in group B than in group A. CONCLUSION ( S ) The use of sutures on ovaries treated for endometrioma is associated with a lower rate of postoperative ovarian adhesion formation compared with bipolar coagulation Thirty-four women with unruptured tubal ectopic pregnancy ( EP ) were r and omly assigned to undergo salpingotomy without tubal suturing ( n = 15 ) or salpingotomy with tubal suturing ( n = 19 ) . The reproductive performance of these patients was compared with 24 patients who underwent salpingectomy for their EP ( historical control ) . Using life table analysis , the cumulative probability of intrauterine pregnancy ( IUP ) at 12 and 24 months was 45 % and 45 % after salpingotomy without tubal suturing and 21 % and 47 % after salpingotomy with tubal suturing , respectively . The cumulative probability of IUP after salpingectomy ( 21 % and 26 % at 12 and 24 months , respectively ) was significantly lower than after salpingotomy with or without tubal suturing . There was no difference in the cumulative probability of EP after salpingotomy with or without tubal suturing , but it was significantly higher than after salpingectomy . In 18 women who subsequently underwent laparoscopy or laparotomy  , no significant difference was found between the degree of adhes 
    Output:
    
agent
None of the techniques that were compared significantly reduced the incidence of adhesive small bowel obstruction .
None of the specific techniques that were compared reduced the two main adhesion-related clinical outcomes , small bowel obstruction and infertility .
The meta- analysis provides little evidence for the surgical principle that using less invasive techniques , introducing less foreign bodies or causing less ischaemia reduces the extent and severity of adhesions
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Laparoscopic Nd-YAG laser photocoagulation of the ovaries was performed in 40 anovulatory women with clomiphene citrate-resistant polycystic ovary disease . Following this procedure , the subjects were r and omly assigned to have either a second-look laparoscopy with lysis of adhesions within 3 - 4 weeks of the initial laparoscopy ( N=19 ) or expectant management ( N=20 ) . One patient assigned to the laparoscopy group refused the procedure . Minimal and mild adhesions that did not distort the normal tubo-ovarian relationship were encountered in 13 patients ( 68 % ) in the second-look laparoscopy group ; these adhesions were easily lysed using sharp or blunt dissection . The pregnancy rates over 6 months were similar in the two groups ( 47 % in the second-look group and 55 % in the expectant-management group ; P>.05 ) . These data suggest that early laparoscopic lysis of adhesions does not improve short-term conception rates following laparoscopic Nd-YAG laser photocoagulation of polycystic ovaries This study describes a prospect i ve r and omized controlled trial to evaluate whether suture of the peritoneal layer is necessary as a separate step in the closure of midline abdominal surgical wounds . Consecutive patients undergoing abdominal operation — elective and emergency surgery — through a midline abdominal wound were r and omized to have the peritoneal layer closed with continuous catgut , or to have this step omitted . The linea alba was closed with interrupted stainless steel sutures , and the skin approximated with staples . Patients were evaluated for wound sepsis , wound dehiscence , and subsequent incisional hernia development . Postoperative pain was assessed by a self-administered visual analogue score , and by measuring narcotic requirements . There was no significant difference in narcotic requirements , pain scores , or wound complications between the 2 groups . Single-layer closure of the abdominal wall is quicker , less costly , and theoretically safer than layered closure , and it is recommended that separate suture of the peritoneum be ab and oned . ResuméDans cette étude prospect i ve , r and omisée , et contrôlée , nous avons cherché à savoir si la fermeture individualisée du péritoine était nécessaire dans la fermeture d'une laparotomie médiane . Deux cents patients consécutifs — opérés à froid ou en urgence — par laparotomie médiane  , ont été r and omisés : dans un groupe , le péritoine a été fermé en un plan individualisé par un surjet au catgut , dans l'autre , le péritoine n'a pas été suturé . La ligne blanche a été fermée en un plan par des points séparés de fils d'acier ; la peau a été fermée par des agrafes . On a étudié le nombre des abcès de paroi , des éviscérations , et , à distance , des éventrations . La douleur postopératoire a été évaluée par un score analogue visuel , établi par le patient lui-même , ainsi que par la nécessité d'utiliser des antalgiques . Il n'y avait pas de différence significative entre les 2 groupes en ce qui concerne le taux de complications pariétales ou l'existence de douleur . Comme la fermeture pariétale en un seul plan est plus rapide , coûte moins cher , et , est théoriquement plus sûre ( on peut surveiller le contenu intrapéritonéal pendant la fermeture ) que la fermeture plan par plan , nous recomm and ons d'ab and oner la fermeture individualisée du péritoine . ResumenEl presente articulo describe un ensayo clínico prospect ivo destinado a investigar si es necesaria la sutura de la capa peritoneal como un paso independiente en el cierre de incisiones abdominales de línea media . Una serie de pacientes consecutivos sometidos a operaciones abdominales fueron r and omizados a cierre peritoneal con sutura continua de catgut  o a omisión de este paso . La línea alba fue cerrada con suturas interrumpidas de acero inoxidable y la piel con agrafes . Se estudió la incidencia de infección de herida , de dehiscencia , y de desarrollo de hernia incisional subsiguientes . La valoración del dolor postoperatorio fue realizada mediante autoevaluación con una escala linear análoga y la determinación de los requerimientos de narcóticos . No se encontraron diferencias significativas en el requerimiento de narcóticos para analgesia , en el nivel de la escala de dolor , o en la tasa de complicaciones entre los 2 grupos . El cierre de la pared abdominal en una capa única es más rápido , menos costoso , y teóricamente más seguro ; por lo tanto , se recomienda ab and onar la sutura del peritoneo OBJECTIVE To determine the effect of closure or non-closure of the visceral peritoneum at cesarean delivery on uterine scar formation assessed at repeat cesarean delivery . METHODS Women undergoing initial cesarean delivery were allocated into 2 groups : group 1 underwent visceral peritoneal closure , while in group 2 the visceral peritoneum was not closed . At repeat cesarean delivery 4 specimens from the initial uterine scar were collected and assessed by light microscopy and scanning electron microscopy . RESULTS In group 1 , 57 % of women had adhesions compared with 20.6 % in group 2 ( P<0.05 ) . Light microscopy revealed reactive mesothelial hyperplasia ( 51.8 % vs 13.7 % ) , submesothelial fibrosis ( 48.1 % vs 6.8 % ) , and neoangiogenesis of mesothelial stroma ( 44.4 % vs 12 % ) in group 1 and group 2 patients , respectively ( P<0.05 ) . Scanning electron microscopy showed more patients with pericytes on the surface of microvessels in group 1 compared with group 2 ( 26.3+/-1.4 vs 11.5+/-1.1 patients ; P<0.05 ) . CONCLUSION Closure of the visceral peritoneum at cesarean delivery may produce an inflammatory reaction and adhesions , evidence d by reactive and regenerative mesothelial hyperplasia and submesothelial fibrosis Objectives Laparoscopic ovarian drilling ( LOD ) has been put forward as the treatment of choice in women with clomiphene citrate (CC)-resistant polycystic ovary syndrome ( PCOS ) , with tubo-ovarian adhesion formation as the major disadvantage . Our study proposed to compare the efficacy of laparoscopic unilateral ovarian drilling with bilateral ovarian drilling in terms of ovulation and pregnancy rate with the expected advantage of decreasing postoperative adhesion rate and change in fimbiro ovarian relationship with unilateral drilling . Methods This prospect i ve r and omized study included 44 patients with anovulatory infertility due to PCOS . Twenty-two patients underwent unilateral ovarian drilling  in group-I and 22 patients underwent bilateral ovarian drilling in group-II between June 2005 and June 2007 . The number of drilling site in each ovary was limited to five . The clinical and biochemical response , ovulation and pregnancy rates over a follow-up period of 1 year were compared . Tubo-ovarian adhesion rate was compared during cesarean section or during repeat laparoscopy . Results There was no statistical difference between the two groups in terms of clinical and biochemical response , ovulation rate and pregnancy rate . Postoperatively , tubo-ovarian adhesions could be assessed in 36.3 % of the patients and no adhesions were found in a single case in either group . Conclusion Unilateral drilling cauterization of ovary is equally efficacious as bilateral drilling in inducing ovulation and achieving pregnancy .  Unilateral ovarian drilling may be a suitable option in clomiphene citrate resistant infertility patient of PCOS which can replace bilateral ovarian drilling with the potential advantage of decreasing the chances of adhesion formation BACKGROUND The purpose of this study was to analyze long-term recurrence rates and complications in patients previously enrolled in a prospect i ve r and omized trial comparing laparoscopic ( LC ) and open ileocolectomy ( OC ) for ileocolic Crohn 's disease ( CD ) . METHODS Follow-up data were available on 56 of 60 patients .  Demographic data , recurrence rates , need for additional surgery related to primary procedure , and medication use were recorded . RESULTS Mean follow-up for 56 patients ( 27 LC vs 29 OC ) was 10.5 years and comparable between LC and OC ( 10.0 vs 11.0 , respectively ; P = .64 ) . One patient died 8 years after OC of causes unrelated to CD . Eight patients for each group underwent initial reoperative ( 26 % LC vs 28 % OC ; P = .89 ) . One patient underwent incisional hernia repair  after LC ( 4 % ) versus 4 patients ( 14 % ) after OC ( P = .61 ) . Two patients in the LC group underwent  adhesiolysis  versus none after OC ( P = .23 ) . Incidences of anorectal disease , anorectal surgery , endoscopic or radiologic recurrence , and medication use were also similar between LC and OC . OC patients requiring operation during follow-up were significantly more likely than LC to require multiple operations ( P = .006 ) . CONCLUSIONS Long-term data from this prospect i ve r and omized trial confirm that LC is at least comparable to OC in the treatment of ileocolic CD OBJECTIVE To assess the rate of adhesions and other long-term outcomes of two cesarean delivery techniques . METHODS A total of 600 women were r and omly assigned to either a st and ard ( Pfannenstiel-Kerr ) or modified ( Joel-Cohen-Stark ) technique for first-time cesarean delivery . A total of 124 women were assessed at repeat cesarean delivery . The primary outcome measure was the presence of adhesions . RESULTS At repeat cesarean delivery , anesthesia-to-delivery time , total duration of surgery , change in hemoglobin level , time to mobilization and oral intake , and postoperative hospital stay were significantly less with the modified technique . Adhesions were found in 7 ( 11.3 % ) and 22 ( 35.5 % ) of the cases using the modified and st and ard techniques , respectively ( P=0.0026 ; relative risk 3.14 [ 95 % CI , 1.45 - 6.82 ] ) . CONCLUSION A modified cesarean delivery technique , including Joel-Cohen incision , exteriorized full thickness suturing of the uterine incision , and non-closure of the peritoneum may reduce long-term morbidities of the procedure OBJECTIVE To compare bipolar coagulation and suturing of the ovary in terms of postoperative ovarian adhesions after  laparoscopic ovarian cystectomy for endometriosis . DESIGN Prospect i ve , r and omized , controlled study . SETTING Department of Obstetrics and Gynecology , University of Naples " Federico II . " PATIENT(S ) Thirty-two women with a single endometriotic cyst were r and omly divided into two groups of 16 women each ( groups A and B ) . INTERVENTION(S ) All patients underwent laparoscopic ovarian cystectomy for endometriosis . In group A , hemostasis was performed by closure of the ovary with an intraovarian suture . In group B , complete hemostasis was achieved only with bipolar coagulation on the internal face of the ovary . MAIN OUTCOME MEASURE(S ) Rate and extension of postsurgical ovarian adhesions at 60 - 90 days follow-up . RESULT ( S ) At follow-up , a significantly lower rate of postsurgical ovarian adhesions was observed in group A than in group B ( 30.8 % vs. 57.1 % ) . The extension of ovarian adhesions was significantly higher in group B than in group A. CONCLUSION ( S ) The use of sutures on ovaries treated for endometrioma is associated with a lower rate of postoperative ovarian adhesion formation compared with bipolar coagulation Thirty-four women with unruptured tubal ectopic pregnancy ( EP ) were r and omly assigned to undergo salpingotomy without tubal suturing ( n = 15 ) or salpingotomy with tubal suturing ( n = 19 ) . The reproductive performance of these patients was compared with 24 patients who underwent salpingectomy for their EP ( historical control ) . Using life table analysis , the cumulative probability of intrauterine pregnancy ( IUP ) at 12 and 24 months was 45 % and 45 % after salpingotomy without tubal suturing and 21 % and 47 % after salpingotomy with tubal suturing , respectively . The cumulative probability of IUP after salpingectomy ( 21 % and 26 % at 12 and 24 months , respectively ) was significantly lower than after salpingotomy with or without tubal suturing . There was no difference in the cumulative probability of EP after salpingotomy with or without tubal suturing , but it was significantly higher than after salpingectomy . In 18 women who subsequently underwent laparoscopy or laparotomy  , no significant difference was found between the degree of adhes 
    Output:
    