title: Safety and Efficacy of Sodium Hyaluronate Gel and Chitosan in Preventing Postoperative Peristomal Adhesions After Defunctioning Enterostomy: A Prospective Randomized Controlled Trials.
abstract: Peristomal adhesions complicate closure of defunctioning enterostomy. The efficacy and safety of sodium hyaluronate gel and chitosan in preventing postoperative adhesion have not been extensively studied. This study aims to evaluate the safety and efficacy of sodium hyaluronate gel and chitosan in the prevention of postoperative peristomal adhesions.This was a prospective randomized controlled study. One hundred and fourteen patients undergoing defunctioning enterostomy were enrolled. Patients were randomly assigned to receive sodium hyaluronate gel (SHG group) or chitosan (CH group) or no antiadhesion treatment (CON group) during defunctioning enterostomy. The safety outcomes included toxicities, stoma-related complications, and short-term and long-term postoperative complications. Eighty-seven (76.3%) of the 114 patients received closure of enterostomy, during which occurrence and severity of intra-abdominal adhesions were visually assessed by a blinded assessor.Incidence of adhesion appears to be lower in patients received sodium hyaluronate gel or chitosan but differences did not reach a significant level (SHG group vs CH group vs CON group: 62.1% vs 62.1% vs 82.8%, P = 0.15). Compared with the CON group, severity of postoperative adhesion was significantly decreased in the SHG and CH group (SHG group vs CH group vs CON group: 31.0% vs 27.6% vs 62.1%; P = 0.01). There was no significant difference in the occurrence of postoperative complications and other safety outcomes among the 3 groups.Sodium hyaluronate gel or chitosan smeared around the limbs of a defunctioning enterostomy was safe and effective in the prevention of postoperative peristomal adhesions.
authors.affiliation: From the Department of Colorectal Surgery (JH, DF, XL, XW, XH, XH, XW, PL); the Department of Digestive Endoscopy (DF, XL); Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital, Sun Yat-sen University (JH, DF, XL, XW, XH, XH, XW, PL); and Guangdong Institute of Gastroenterology, Guangzhou, Guangdong, China (JH, DF, XL, XW, XH, XH, XW, PL).
authors.forename: Jiancong
authors.initials: J
authors.lastname: Hu
authors.forename: Dejun
authors.initials: D
authors.lastname: Fan
authors.forename: Xutao
authors.initials: X
authors.lastname: Lin
authors.forename: Xianrui
authors.initials: X
authors.lastname: Wu
authors.forename: Xiaosheng
authors.initials: X
authors.lastname: He
authors.forename: Xiaowen
authors.initials: X
authors.lastname: He
authors.forename: Xiaojian
authors.initials: X
authors.lastname: Wu
authors.forename: Ping
authors.initials: P
authors.lastname: Lan
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D048271:Chitosan / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004766:Enterostomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D054047:Surgical Stomas; D000267:Tissue Adhesions / Q000517:prevention & control*
chemical_list: D006820:Hyaluronic Acid; D048271:Chitosan