title: Reduction of postoperative abdominal adhesion and ileus by a bioresorbable membrane.
abstract: OBJECTIVE
  This study examines the efficacy of a bioresorbable sodium hyaluronate-carboxy-methylcellulose-based membrane (HA/CMC membrane) in reducing postoperative abdominal adhesion and ileus after intestinal resection. Also, this study attempts to identify the possible factors that influence effectiveness through qualitative analysis of an individual patient case.
  
  
  METHODS
  Bioresorable membranes were applied just prior to abdominal closure in 121 patients who underwent abdominal surgery. The incidence of adhesion-related postoperative ileus was compared between the treatment and control group. Severity and extent of adhesions were also examined in 27 patients who underwent follow-up laparotomy.
  
  
  RESULTS
  The incidence of postoperative ileus was low in the treatment group. For the partial colectomies with lymph node dissection for colorectal cancers, there was no difference between the treatment and control group in the incidence of postoperative ileus. In patients who underwent a second operation, the incidence and severity of adhesions were significantly lower for the treated area compared with the untreated area.
  
  
  CONCLUSIONS
  HA/CMC membrane was effective in reducing postoperative abdominal adhesions. The incidence of adhesion-related postoperative ileus after colorectal cancer surgery was unchanged. The results of qualitative analysis imply that further improvement of application may allow HA/CMC membrane to be more effective in reducing postoperative ileus.
authors.affiliation: Department of Surgery, Gastroenterological Center, Yokohama City University, Yokohama, Japan. u0970047@urahp.yokohama-cu.ac.jp
authors.forename: Shoichi
authors.initials: S
authors.lastname: Fujii
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimada
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ike
authors.forename: Chikara
authors.initials: C
authors.lastname: Kunisaki
authors.forename: Shigeo
authors.initials: S
authors.lastname: Ohki
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ichikawa
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Ohta
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yamagishi
authors.forename: Shunichi
authors.initials: S
authors.lastname: Osada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000627:therapeutic use*; D015331:Cohort Studies; D003082:Colectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D045823:Ileus / Q000453:epidemiology*; D015994:Incidence; D007813:Laparotomy / Q000009:adverse effects*; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000453:epidemiology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D008567:Membranes, Artificial; C118198:Seprafilm; D006820:Hyaluronic Acid