title: Direct comparison of Seprafilm® versus Adept ® versus no additive for reducing the risk of small-bowel obstruction in colorectal cancer surgery.
abstract: OBJECTIVE
  To assess the effectiveness of using sodium hyaluronate-based bioresorbable membrane (Seprafilm(®)) versus 4 % icodextrin solution (Adept(®)) versus no additive intraoperatively and to prevent postoperative small-bowel obstruction in patients undergoing colorectal cancer (CRC) surgery.
  
  
  METHODS
  The subjects of this retrospective study were 454 patients, who underwent CRC surgery between February 2007 and January 2010. Among the 454 enrolled patients, 114 patients received Seprafilm(®), 180 patients received Adept(®), and 160 patients received no additive, based on the year of their surgery.
  
  
  RESULTS
  The overall incidences of small-bowel obstruction were 8.8, 4.3, and 6.9 %, for the Adept(®), Seprafilm(®), and no additive (control) groups, respectively. The cumulative incidence was significantly higher in the Adept(®) group than in the Seprafilm(®) and control groups (Adept(®) vs. Seprafilm(®), P = 0.043; Adept(®) vs. control group, P = 0.002). No significant difference was found between the Seprafilm group and the control group (P = 0.549). Adept(®) solution and Seprafilm(®) did not alter the liver and renal function, as assessed by blood chemistry.
  
  
  CONCLUSIONS
  The use of Adept(®) significantly increased the incidence of small-bowel obstruction in patients undergoing CRC surgery.
authors: Department of Surgery, Gil Medical Center, Gachon University, 1198 Guwol-dong, Namdong-gu, Incheon 405-760, Korea. lws@gilhospital.com
authors: Won-Suk
authors: WS
authors: Lee
authors: Jeong Heum
authors: JH
authors: Baek
authors: Woon Kee
authors: WK
authors: Lee
mesh_terms: D003082:Colectomy; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D005936:Glucans / Q000008:administration & dosage* / Q000009:adverse effects*; D005947:Glucose / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D000077607:Icodextrin; D015994:Incidence; D007415:Intestinal Obstruction / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D007421:Intestine, Small; D007430:Intraoperative Care / Q000379:methods*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012306:Risk
chemical_list: D005936:Glucans; C118198:Seprafilm; D000077607:Icodextrin; D006820:Hyaluronic Acid; D005947:Glucose
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