Abstract | BACKGROUND: There is no clear consensus on the efficacy and safety of hyaluronate- carboxymethylcellulose membrane ( Seprafilm) for preventing postoperative abdominal adhesion. This study is a meta-analysis of the available evidence. METHODS: A search of the MEDLINE, EMBASE, and the Cochrane Library identified eight studies that met the inclusion criteria for data extraction. Estimates of effectiveness were performed using fixed- and random-effects models. The effect was calculated as an odds ratio (OR) with 95% confidence intervals (CI) using the statistical software Review Manager Version 4.2. Level of significance was set at p < 0.05. RESULTS: Outcomes of 4203 patients were studied. The incidence of grade 0 adhesions among Seprafilm-treated patients was statistically significantly more than that observed among control group patients (OR 95%CI, 3.74-20.34; p < 0.01). There was no significant difference in the incidence of grade 1 adhesions between Seprafilm and control groups (OR 95%CI, 0.58-2.71; p = 0.56). The severity of grade 2 and grade 3 adhesions among Seprafilm-treated patients was significantly less than that observed among control group patients (OR 95%CI, 0.22-0.93; p = 0.03; OR 95%CI, 0.09-0.63; p < 0.01, respectively). The incidence of intestinal obstruction after abdominal surgery was not different between Seprafilm and control groups (OR 95%CI, 0.78-1.23; p = 0.84). Using Seprafilm significantly increased the incidence of abdominal abscesses (OR 95%CI, 1.06-2.54; p = 0.03) and anastomotic leaks (OR 95%CI, 1.18-3.50; p = 0.01). CONCLUSIONS:
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Authors | Qiqiang Zeng, Zhengping Yu, Jie You, Qiyu Zhang |
Journal | World journal of surgery
(World J Surg)
Vol. 31
Issue 11
Pg. 2125-31; discussion 2132
(Nov 2007)
ISSN: 0364-2313 [Print] United States |
PMID | 17899250
(Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
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Chemical References |
- Membranes, Artificial
- Seprafilm
- Hyaluronic Acid
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Topics |
- Abscess
(epidemiology)
- Humans
- Hyaluronic Acid
(therapeutic use)
- Membranes, Artificial
- Postoperative Complications
(epidemiology, prevention & control)
- Randomized Controlled Trials as Topic
- Tissue Adhesions
(prevention & control)
- Treatment Outcome
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