Reduction of postoperative abdominal adhesion and ileus by a bioresorbable membrane.
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.
Fujii
Shoichi
S
Department of Surgery, Gastroenterological Center, Yokohama City University, Yokohama, Japan. u0970047@urahp.yokohama-cu.ac.jp
Shimada
Hiroshi
H
Ike
Hideyuki
H
Kunisaki
Chikara
C
Ohki
Shigeo
S
Ichikawa
Yasushi
Y
Ohta
Mitsuyoshi
M
Yamagishi
Shigeru
S
Osada
Shunichi
S
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
D001672:Biocompatible Materials; D008567:Membranes, Artificial; C118198:Seprafilm; D006820:Hyaluronic Acid