Top

Surgery Today

Published in:

01-09-2013 | Original Article

Direct comparison of Seprafilm^® versus Adept^® versus no additive for reducing the risk of small-bowel obstruction in colorectal cancer surgery

Authors: Won-Suk Lee, Jeong Heum Baek, Woon Kee Lee

Published in: Surgery Today | Issue 9/2013

Abstract

Purpose

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.

Menzies D, Parker M, Hoare R, Knight A. Small bowel obstruction due to postoperative adhesions: treatment patterns and associated costs in 110 hospital admissions. Ann R Coll Surg Engl. 2001;83:40–6.PubMed

Becker JM, Dayton MT, Fazio VW, Beck DE, Stryker SJ, Wexner SD, Wolff BG, Roberts PL, Smith LE, Sweeney SA, Moore M. Prevention of postoperative abdominal adhesions by a sodium hyaluronate-based bioresorbable membrane: a prospective, randomized, double-blind multicenter study. J Am Coll Surg. 1996;183:297–306.PubMed

Diamond MP, Freeman ML. Clinical implications of postsurgical adhesions. Hum Reprod Update. 2001;7:567–76.PubMedCrossRef

Kusunoki M, Ikeuchi H, Yanagi H, Noda M, Tonouchi H, Mohri Y, Uchida K, Inoue Y, Kobayashi M, Miki C, Yamamura T. Bioresorbable hyaluronate-carboxymethylcellulose membrane (Seprafilm) in surgery for rectal carcinoma: a prospective randomized clinical trial. Surg Today. 2005;35:940–5.PubMedCrossRef

Salum M, Wexner SD, Nogueras JJ, Weiss E, Koruda M, Behrens K, Cohen S, Binderow S, Cohen J, Thorson A, Ternent C, Christenson M, Blatchford G, Pricolo V, Whitehead M, Doveney K, Reilly J, Glennon E, Larach S, Williamson P, Gallagher J, Ferrara A, Harford F, Fry R, Eisenstat T, Notaro J, Chinn B, Yee L, Stamos M, Cole P, Dunn G, Singh A. Does sodium hyaluronate- and carboxymethylcellulose-based bioresorbable membrane (Seprafilm) decrease operative time for loop ileostomy closure? Tech Coloproctol. 2006;10:187–90. (discussion 190-181).PubMedCrossRef

Vrijland WW, Tseng LN, Eijkman HJ, Hop WC, Jakimowicz JJ, Leguit P, Stassen LP, Swank DJ, Haverlag R, Bonjer HJ, Jeekel H. Fewer intraperitoneal adhesions with use of hyaluronic acid-carboxymethylcellulose membrane: a randomized clinical trial. Ann Surg. 2002;235:193–9.PubMedCrossRef

Oikonomakis I, Wexner SD, Gervaz P, You SY, Secic M, Giamundo P. Seprafilm: a retrospective preliminary evaluation of the impact on short-term oncologic outcome in colorectal cancer. Dis Colon Rectum. 2002;45:1376–80.PubMedCrossRef

Salum MR, Lam DT, Wexner SD, Pikarsky A, Baig MK, Weiss EG, Nogueras JJ, Singh JJ. Does limited placement of bioresorbable membrane of modified sodium hyaluronate and carboxymethylcellulose (Seprafilm) have possible short-term beneficial impact? Dis Colon Rectum. 2001;44:706–12.PubMedCrossRef

Fazio VW, Cohen Z, Fleshman JW, van Goor H, Bauer JJ, Wolff BG, Corman M, Beart RW Jr, Wexner SD, Becker JM, Monson JR, Kaufman HS, Beck DE, Bailey HR, Ludwig KA, Stamos MJ, Darzi A, Bleday R, Dorazio R, Madoff RD, Smith LE, Gearhart S, Lillemoe K, Gohl J. Reduction in adhesive small-bowel obstruction by Seprafilm adhesion barrier after intestinal resection. Dis Colon Rectum. 2006;49:1–11.PubMedCrossRef

10.

Verco SJ, Peers EM, Brown CB, Rodgers KE, Roda N, diZerega G. Development of a novel glucose polymer solution (icodextrin) for adhesion prevention: pre-clinical studies. Hum Reprod. 2000;15:1764–72.PubMedCrossRef

11.

Brown CB, Luciano AA, Martin D, Peers E, Scrimgeour A, diZerega GS. Adept (icodextrin 4 % solution) reduces adhesions after laparoscopic surgery for adhesiolysis: a double-blind, randomized, controlled study. Fertil Steril. 2007;88:1413–26.PubMedCrossRef

12.

Park CM, Lee WY, Cho YB, Yun HR, Lee WS, Yun SH, Chun HK. Sodium hyaluronate-based bioresorbable membrane (Seprafilm) reduced early postoperative intestinal obstruction after lower abdominal surgery for colorectal cancer: the preliminary report. Int J Colorectal Dis. 2009;24:305–10.PubMedCrossRef

13.

diZerega GS, Verco SJ, Young P, Kettel M, Kobak W, Martin D, Sanfilippo J, Peers EM, Scrimgeour A, Brown CB. A randomized, controlled pilot study of the safety and efficacy of 4 % icodextrin solution in the reduction of adhesions following laparoscopic gynaecological surgery. Hum Reprod. 2002;17:1031–8.PubMedCrossRef

14.

Hayashi S, Takayama T, Masuda H, Kochi M, Ishii Y, Matsuda M, Yamagata M, Fujii M. Bioresorbable membrane to reduce postoperative small bowel obstruction in patients with gastric cancer: a randomized clinical trial. Ann Surg. 2008;247:766–70.PubMedCrossRef

15.

Schnuriger B, Barmparas G, Branco BC, Lustenberger T, Inaba K, Demetriades D. Prevention of postoperative peritoneal adhesions: a review of the literature. Am J Surg. 2011;201:111–21.PubMedCrossRef

16.

Korenaga D, Yasuda M, Takesue F, Honda M, Inutsuka S, Nagahama S, Maekawa S. Factors influencing the development of small intestinal obstruction following total gastrectomy for gastric cancer: the impact of reconstructive route in the Roux-en-Y procedure. Hepatogastroenterology. 2001;48:1389–92.PubMed

17.

Ray NF, Denton WG, Thamer M, Henderson SC, Perry S. Abdominal adhesiolysis: inpatient care and expenditures in the United States in 1994. J Am Coll Surg. 1998;186:1–9.PubMedCrossRef

18.

Beck DE, Cohen Z, Fleshman JW, Kaufman HS, van Goor H, Wolff BG. A prospective, randomized, multicenter, controlled study of the safety of Seprafilm adhesion barrier in abdominopelvic surgery of the intestine. Dis Colon Rectum. 2003;46:1310–9.PubMedCrossRef

19.

Oncel M, Remzi FH, Senagore AJ, Connor JT, Fazio VW. Comparison of a novel liquid (Adcon-P) and a sodium hyaluronate and carboxymethylcellulose membrane (Seprafilm) in postsurgical adhesion formation in a murine model. Dis Colon Rectum. 2003;46:187–91.PubMedCrossRef

20.

Rodgers KE, Verco SJ, diZerega GS. Effects of intraperitoneal 4 % icodextrin solution on the healing of bowel anastomoses and laparotomy incisions in rabbits. Colorectal Dis. 2003;5:324–30.PubMedCrossRef

21.

Tang CL, Jayne DG, Seow-Choen F, Ng YY, Eu KW, Mustapha N. A randomized controlled trial of 0.5 % ferric hyaluronate gel (Intergel) in the prevention of adhesions following abdominal surgery. Ann Surg. 2006;243:449–55.PubMedCrossRef

22.

van den Tol P, ten Raa S, van Grevenstein H, Marquet R, van Eijck C, Jeekel H. Icodextrin reduces postoperative adhesion formation in rats without affecting peritoneal metastasis. Surgery. 2005;137:348–54.PubMedCrossRef

23.

Catena F, Ansaloni L, Di Saverio S, Pinna AD. P.O.P.A. study: prevention of postoperative abdominal adhesions by icodextrin 4 % solution after laparotomy for adhesive small bowel obstruction. A prospective randomized controlled trial. J Gastrointest Surg. 2012;16:382–8.PubMedCrossRef

24.

Menzies D, Pascual MH, Walz MK, Duron JJ, Tonelli F, Crowe A, Knight A. Use of icodextrin 4 % solution in the prevention of adhesion formation following general surgery: from the multicentre ARIEL Registry. Ann R Coll Surg Engl. 2006;88:375–82.PubMedCrossRef

25.

Rajab TK, Wallwiener M, Planck C, Brochhausen C, Kraemer B, Wallwiener CW. A direct comparison of seprafilm, adept, intercoat, and spraygel for adhesion prophylaxis. J Surg Res. 2010;161:246–9.PubMedCrossRef

Title: Direct comparison of Seprafilm® versus Adept® versus no additive for reducing the risk of small-bowel obstruction in colorectal cancer surgery
Authors: Won-Suk Lee
Jeong Heum Baek
Woon Kee Lee
Publication date: 01-09-2013
Publisher: Springer Japan
Published in: Surgery Today / Issue 9/2013
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-013-0490-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Direct comparison of Seprafilm^® versus Adept^® versus no additive for reducing the risk of small-bowel obstruction in colorectal cancer surgery

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2013

Bowline knot of a monofilament suture eliminates C-loop formation in intracorporeal ligation

Key techniques for orthotopic liver transplantation model with a 30 % graft in swine

Successful treatment of a large primary cardiac lymphoma by surgical resection combined with chemotherapy: report of a case

Analysis of the efficacy of direct hemoperfusion with polymyxin B-immobilized fiber (PMX-DHP) according to the prognostic factors in patients with colorectal perforation

Management of postoperative hemorrhage associated with factor VIII inhibitor: report of a case

Infradiaphragmatic malperfusion of acute aortic dissection associated with previous abdominal aortic aneurysm repair