Preventive effects of a synthetic absorbable antiadhesive film (seprafilm) on small bowel obstruction in patients who underwent elective surgery for colon cancer: A randomized controlled trial.

Abstract

BACKGROUND:

Seprafilm did not decrease small bowel obstruction (SBO), but significantly decreased reoperation in patients with inflammatory bowel disease. However, the preventive effect in colon cancer remains unclear.

METHODS:

We conducted a randomized controlled trial in patients with colon cancer. The study group comprised 345 patients with colon cancer. In the seprafilm group (n = 166), two sheets of seprafilm were inserted under a midline incision. Patients who were admitted and required decompression were considered to have SBO.

RESULTS:

The median follow-up was 61.9 months. Patient characteristics were well balanced. There was no significant difference in the incidence of SBO between the seprafilm group (7.8%) and the control group (10.6%) (P = .46). In patients who underwent reoperation, SBO occurred in a midline incision in one patient and at other sites in four patients in the seprafilm group as compared with two patients and five patients, respectively, in the control group. Multivariate analysis showed that only a history of laparotomy was an independent risk factor for SBO.

CONCLUSIONS:

Seprafilm did not decrease SBO or reoperation in colon cancer. The incidence of SBO caused by adhesion to the midline incision was relatively low as compared with that caused by adhesion to other sites.

• Authors: Gota Saito, Sotaro Sadahiro, Takashi Ogimi, Hiroshi Miyakita, Kazutake Okada, Akira Tanaka, Toshiyuki Suzuki
• Journal: Journal of surgical oncology (J Surg Oncol) Vol. 120 Issue 6 Pg. 1038-1043 (Nov 2019) ISSN: 1096-9098 [Electronic] United States
• PMID: 31392725 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: © 2019 Wiley Periodicals, Inc.

Chemical References

• Seprafilm
• Hyaluronic Acid

Topics

• Adult
• Aged
• Aged, 80 and over
• Case-Control Studies
• Colectomy (adverse effects)
• Colonic Neoplasms (pathology, surgery)
• Elective Surgical Procedures (adverse effects)
• Female
• Follow-Up Studies
• Humans
• Hyaluronic Acid (therapeutic use)
• Intestinal Obstruction (etiology, pathology, prevention & control)
• Intestine, Small (pathology)
• Male
• Middle Aged
• Postoperative Complications
• Prognosis
• Tissue Adhesions