L-Glutamine for Surgery: Can It Prevent Scar Tissue?

randomized-controlled-trial PMID: 37023559

Quick Summary: A study found that a special form of L-glutamine, called alanyl-glutamine, helped reduce scar tissue (adhesions) after a specific type of surgery. This could mean fewer complications and a smoother recovery for some patients.

What The Research Found

Researchers looked at how alanyl-glutamine affected women who had surgery to remove uterine fibroids (myomectomy). They found that giving alanyl-glutamine during surgery significantly reduced the formation of adhesions, which are like internal scars that can cause pain and other problems. In fact, almost all patients who received alanyl-glutamine had no adhesions at all in certain areas!

Study Details

Who was studied: 48 women who had myomectomy surgery (some by laparoscopy, some by laparotomy).

How long: The study followed patients for 6-8 weeks after surgery.

What they took: During surgery, some women received a dose of alanyl-glutamine directly into their abdomen. Others received a placebo (a "dummy" treatment).

What This Means For You

This research is promising for women undergoing myomectomy. It suggests that alanyl-glutamine could potentially:

Reduce the risk of painful adhesions after surgery.

Lead to a faster and easier recovery.

Potentially reduce the need for future surgeries related to adhesions.

Important Note: This study used a specific form of L-glutamine (alanyl-glutamine) and it was administered directly into the abdomen during surgery. This is not the same as taking L-glutamine supplements orally. More research is needed to see if oral L-glutamine has the same effect.

Study Limitations

It's important to keep these things in mind:

The study was relatively small, so more research is needed to confirm the findings.

The study only looked at the short-term effects (6-8 weeks). We don't know if the benefits last longer.

The alanyl-glutamine was given directly during surgery, not as an oral supplement.

The study was done in one hospital, so the results might not be the same everywhere.

Key Findings

Intraperitoneal administration of L-alanyl-L-glutamine (AG) significantly reduced post-operative adhesion formation after laparoscopic myomectomy. AG decreased adhesion incidence (p=0.046), severity, and extent compared to placebo. Post-hoc analysis revealed 93% of AG-treated patients had complete absence of adhesions at all abdominal sites. No serious adverse events were reported, confirming AG’s safety and tolerability in this surgical context.

Study Design

This phase 1/2 randomized, double-blind, placebo-controlled trial enrolled 48 women undergoing myomectomy via laparoscopy (n=38) or laparotomy (n=10). Participants were split into AG and placebo groups (19 vs. 19 in laparoscopy; 5 vs. 5 in laparotomy). A second-look laparoscopy (SLL) was performed 6–8 weeks post-surgery to assess adhesions. Adhesion scoring was conducted by three blinded reviewers using digital recordings.

Dosage & Administration

AG was administered intraperitoneally as a single bolus dose (1 g/kg body weight, average volume 170 mL) immediately before suture closure of laparoscopic ports. The placebo group received normal saline (0.9% NaCl) in the same volume. Dosing was weight-based to ensure physiological relevance.

Results & Efficacy

Adhesion Incidence: AG group had lower adhesion presence vs. placebo (p=0.041).
Adhesion Improvement: 15/15 (100%) AG patients showed improvement vs. 5/17 (29.6%) in placebo (p=0.046).
Complete Absence of Adhesions: 93% of AG-treated patients had no adhesions at SLL.
Safety: No significant differences in adverse events, lab parameters, or post-operative complications between groups.

Limitations

Small sample size (n=38 laparoscopy; n=10 laparotomy), limiting statistical power for subgroup analysis.
Only 32/38 laparoscopy patients completed SLL, introducing potential attrition bias.
Short follow-up period (6–8 weeks); long-term efficacy and safety unknown.
Single-center design may reduce generalizability.
Primary endpoint combined incidence, severity, and extent, complicating interpretation of individual effects.

Clinical Relevance

This study demonstrates that intraperitoneal AG effectively reduces post-surgical adhesions in laparoscopic myomectomy patients. However, the administration route (direct surgical delivery) differs from oral supplementation, limiting direct applicability to non-surgical populations. Results suggest AG’s potential as an adjuvant therapy in gynecological surgeries but do not support systemic use for adhesion prevention outside clinical settings. Larger phase 3 trials are needed to validate findings and explore alternative delivery methods.

Source: PubMed (2023)