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.
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
Tsutomu
T
Tabata
Tomohisa
T
Kihira
Takaya
T
Shiozaki
Kouji
K
Tanida
Eiji
E
Kondo
Kenji
K
Nagao
Toshiharu
T
Okugawa
Norimasa
N
Sagawa
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