Efficacy of a sodium hyaluronate-carboxycellulose membrane (seprafilm) for reducing the risk of early postoperative small bowel obstruction in patients with gynecologic malignancies.
OBJECTIVE
To evaluate the effect of a sodium hyaluronate and carboxymethylcellulose membrane (Seprafilm) on early postoperative small bowel obstruction (EPSBO) in patients with gynecologic malignancies.


METHODS
One hundred forty-five patients who had Seprafilm placed during gynecological surgery between April 2002 and March 2007 (Seprafilm group) were compared with a historical control group of patients managed without Seprafilm between January 1997 and March 2002. All patients undergoing primary surgery with pelvic or combined pelvic and para-aortic lymphadenectomy for gynecological malignancies were retrospectively assessed for EPSBO and surgical infections.


RESULTS
The incidence of EPSBO was significantly lower (P < 0.05) in the Seprafilm group (3.1%, 6/191) than in the control group (13.9%, 25/180). According to logistic regression analysis, the use of Seprafilm (odds ratio, 0.18; 95% confidence interval, 0.07-0.47; P < 0.0005) and the performance of pelvic lymphadenectomy alone (odds ratio, 0.27; 95% confidence interval, 0.09-0.78; P < 0.02) were independent predictors of a lower rate of EPSBO. The incidence of surgical infection showed no significant difference between the Seprafilm group (3.6%) and the control group (6.7%).


CONCLUSIONS
Placement of Seprafilm helped to prevent EPSBO and had no significant adverse effect on surgical infections in patients who underwent lymphadenectomy for gynecological malignancy.
Tabata
Tsutomu
T
Department of Obstetrics and Gynecology, Mie University School of Medicine, 2-174 Edobashi, Tsu City, Mie 514-8507, Japan. tabatat@clin.medic.mie-u.ac.jp
Kihira
Tomohisa
T
Shiozaki
Takaya
T
Tanida
Kouji
K
Kondo
Eiji
E
Nagao
Kenji
K
Okugawa
Toshiharu
T
Sagawa
Norimasa
N
D000328:Adult; D002277:Carcinoma / Q000453:epidemiology / Q000601:surgery*; D002483:Cellulose, Oxidized / Q000008:administration & dosage*; D005260:Female; D005833:Genital Neoplasms, Female / Q000453:epidemiology / Q000601:surgery*; D006488:Hemostasis, Surgical / Q000379:methods; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage* / Q000627:therapeutic use; D015994:Incidence; D007415:Intestinal Obstruction / Q000453:epidemiology / Q000517:prevention & control*; D007421:Intestine, Small / Q000187:drug effects / Q000473:pathology; D008567:Membranes, Artificial; D008875:Middle Aged; D008954:Models, Biological; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D002483:Cellulose, Oxidized; D006490:Hemostatics; D008567:Membranes, Artificial; C118198:Seprafilm; D006820:Hyaluronic Acid