Hyaluronic acid-carboxymethylcellulose reduced postoperative bowel adhesions following laparoscopic urologic pelvic surgery: a prospective, randomized, controlled, single-blind study.
BACKGROUND
To assess the anti-adhesive effect of treatment with hyaluronic acid-carboxymethylcellulose following laparoscopic radical prostatectomy.


METHODS
This was a randomized, controlled, single-blind, parallel-group study using hyaluronic acid-carboxymethylcellulose in patients who underwent laparoscopic radical prostatectomy. Sixty patients were enrolled in the study. All patients were randomly assigned to either the hyaluronic acid-carboxymethylcellulose treatment group (n = 30) or the control group (n = 30). Viscera slide ultrasounds and plain X-rays were obtained at enrollment (V0), postoperative week 12 (V1), and 24 (V2). The primary end point was the difference in the excursion distance in the viscera slide ultrasound between V0 and V2.


RESULTS
A total of 50 patients completed this study. The average excursion distance at V2 in the experimental group (n = 25) was significantly longer than in the control group (n = 25, 2.7 ± 1.2 vs. 1.3 ± 1.0 cm, respectively; p < 0.001). The differences in the V0 and V2 excursion distances were significantly higher in the control group than in the experimental group (1.48 ± 1.5 vs. 2.9 ± 1.2 cm, respectively; p < 0.001). None of patients showed adverse events associated with the use of hyaluronic acid-carboxymethylcellulose.


CONCLUSIONS
This randomized study demonstrated that hyaluronic acid-carboxymethylcellulose treatment resulted in a reduction in bowel adhesion to the abdominal wall after laparoscopic pelvic surgery and had good clinical safety.


BACKGROUND
ClinicalTrials.gov Identifier: NCT02773251 Date: May 12, 2016.
Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
U-Syn
US
Ha
Department of Urology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. gostraight@catholic.ac.kr.|Department of Urology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 327, Sosa-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 14647, Republic of Korea. gostraight@catholic.ac.kr.
Jun Sung
JS
Koh
Department of Urology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Kang Jun
KJ
Cho
Department of Urology, Catholic Kwandong University, International St. Mary's Hospital, Incheon, Republic of Korea.
Byung Il
BI
Yoon
Department of Urology, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Kyu Won
KW
Lee
Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Sung Hoo
SH
Hong
Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Ji Youl
JY
Lee
D000368:Aged; D002266:Carboxymethylcellulose Sodium / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects; D016037:Single-Blind Method; D000267:Tissue Adhesions / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D013520:Urologic Surgical Procedures / Q000009:adverse effects*
D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium
Adhesion barrier; Laparoscopy; Postoperative adhesion