Foreign body reaction from anti-adhesion material during follow-up of gynaecological malignancies: Mimicking local recurrence.
BACKGROUND
Gynaecological surgery techniques and instruments have advanced and there is increasing effort to reduce operative complications by preventing adhesion complications after surgery.


OBJECTIVE
The purpose of this study was to evaluate a possible limitation of the Surgi-Wrap(®) anti-adhesion material during clinical follow-up of surgically managed gynaecological malignancies.


METHODS
We retrospectively analysed the medical records and imaging findings of 92 patients who received the Surgi-Wrap(®) anti-adhesion material.


RESULTS
Nine of the 92 patients had local recurrence based on the imaging findings. The positive imaging findings showed focal, isolated and small pelvic lesions without other distant metastasis or recurrence and normal tumour marker levels. Laparoscopic exploration and biopsy were performed in six patients and close clinical follow-up was performed for the other three patients, who had a strong diagnostic impression of a foreign body reaction mimicking a focal recurrence of the tumour. The histological findings of the six laparoscopically-explored patients revealed a foreign body reaction without malignancy in five and recurrence in one case. The rate of foreign body reaction, mimicking a local recurrence, was 5/92 (5.4% of histologically confirmed cases) and 8/92 cases had ambiguous findings between a foreign reaction and local recurrence (8.7% of clinically suspected cases).


CONCLUSIONS
It is important to avoid confusion between benign and recurrent conditions during follow-up for gynaecological malignancies. We suggest avoiding use of Surgi-wrap(®) during cancer surgeries and a need for further studies on the safety of Surgi-wrap(®) in patients with cancer.
Department of Obstetrics and Gynecology, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan, Korea.
Yong-Soon
YS
Kwon
Department of Obstetrics and Gynecology, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan, Korea.
Jae-Young
JY
Gwack
Department of Anesthesiology and Pain Medicine, Uijeongbu St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.
Kyong S
KS
Im
Department of Anesthesiology and Pain Medicine, Uijeongbu St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.
Dong-Il
DI
Choi
D020341:Absorbable Implants / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D005549:Foreign-Body Reaction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology*; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D000072078:Positron Emission Tomography Computed Tomography; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000517:prevention & control
anti- adhesion material; foreign body reaction; gynaecological malignancy