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Neither HA-CMC bioresorbable membrane nor 0.4 per cent HA solution interferes with the development of early anastomotic strength in the colon, and can therefore be safely used to prevent intra-abdominal adhesion formation after performing bowel anastomosis.

Background: A relationship between post-surgical adhesion formation and peritoneal tumour implantation has been proposed. Hyaluronan (HA)-based agents reduce adhesion formation, but the effect on peritoneal tumour is not established. This study investigated the influence of a HA-containing agent on intraperitoneal tumour in an experimental model. Methods: 66 Balb/c mice underwent laparotomy and damage was inflicted to the parietal peritoneum. The animals were randomized into five groups. Groups 1 and 2 received HA-carboxymethylcellulose bioresorbable membrane and no treatment, respectively. Mice in groups 3–5 were injected intraperitoneally with 10⁵ colon 26-B cells after the laparotomy. Treatment consisted of HA membrane, no HA agent and placement of HA membrane on the non-traumatized peritoneal wall, respectively. Animals were killed after 14 days; adhesions were scored in groups 1 and 2, and the tumour mass in groups 3–5. 45 Wag/Rij rats underwent the same procedures and treatment as mice in groups 3–5. In rats, 10⁶ CC-531 cells were injected. Rats were killed after 3 weeks and the tumour mass was scored. Results: HA membrane resulted in a significant reduction of adhesions, but had no major effect on the intraperitoneal tumour mass in mice and rats. Conclusion: HA-carboxymethylcellulose bioresorbable membrane has no major effect on intraperitoneal tumour implantation and growth in an experimental model.

In all cases of abdominal distension, US must be performed and a tumor marker profile consisting of AFP, LDH, testosterone, estradiol, and CA-125 must be established in order to differentiate between benign and malignant processes. When the latter is suspected, additional computerized tomographic scanning must be performed. In this case, a normal tumor marker profile and benign ultrasonographic appearance excluded the possibility of malignancy. Conventional treatment in these large cysts is laparotomy. We propose that complete laparoscopic drainage and extirpation should be the treatment of choice, regardless of cystic size.

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