Absorptive anti-adhesion barrier for the prevention of bowel obstruction after laparoscopic colorectal cancer surgery

Abstract

Abstract:Objectives: The protective efficacy of an absorptive adhesion prevention product (Seprafilm ) against bowel obstruction (BO) during open surgery was demonstrated in a large-scale randomized controlled clinical trial in Europe and America. However, the efficacy of Seprafilm against BO in laparoscopic surgery remains uncertain. The objective of this study was to clarify the protective efficacy of Seprafilm against BO after laparoscopic surgery for colorectal cancer. Methods: From 2009 to 2016, 1328 laparoscopic colorectal resections were performed for colorectal cancer. From 2009, Seprafilm was used for preventing BO in laparoscopic colorectal surgery. The incidence of BO and short-term results were compared between the Seprafilm and non-Seprafilm groups after propensity score matching. Results: Propensity scoring generated 270 matched patients per group for the comparisons between the Seprafilm and non-Seprafilm groups. The two groups showed no significant differences regarding patients' backgrounds. Among all patients, 73.1% (19/26) of BO occurred within 30 days after the surgery. Significantly lower incidences of all grade (2.6% vs. 7.0%; p = 0.016) and grade 2 + 3a (1.5% vs. 5.2%; p = 0.017) BO were observed in the Seprafilm group than in the non-Seprafilm group; no significant difference regarding grade 3b BO (1.1% vs. 1.9%; p = 0.476) was found. A significant difference in BO within 30 days was also noted between the two groups (1.9% vs. 5.2%, p = 0.036). There were no significant differences between the groups regarding anastomotic leakage and deep surgical site infection. Conclusions: Seprafilm was useful for preventing BO, requiring decompression therapy of the bowel, after laparoscopic colorectal surgery without increasing adverse events.

Seprafilm® and adhesive small bowel obstruction in colorectal/gastrointestinal surgery: An Updated Systematic Review

“…With the increase in minimally invasive colorectal surgery performed today, our sub-analysis of laparoscopic operations is relevant. Our results support previous reports that Sepra lm® can reduce intestinal obstruction after laparoscopic surgery, (17) where the reduced trauma from laparoscopic surgery has been shown to prevent adhesion formation in itself (22). By removing this confounder, it gives us con dence that Sepra lm® will continue to remain relevant.…”

“…NR: Not ReportedOf these studies, eight studies focused solely on colorectal resections(11,(14)(15)(16)(17)(18)(19)(20), with four laparoscopic(16)(17)(18)(19)(20) and four open studies(11,14,15,19) (Table2).…”

Intensive surveillance endoscopy for multiple gastrointestinal tumors in a patient with constitutional mismatch repair deficiency: case report

“…In a study of patients with FAP refusing surgery, invasive colorectal cancer was not observed during a median follow-up of 5.1 years and there were no complications, suggesting that endoscopic management might prevent cancer development in patients with FAP [ 10 , 16 ]. On the other hand, partial colectomy with subsequent regular surveillance colonoscopy is recommended in patients with Lynch syndrome and colorectal cancer, although the appropriate interval of surveillance colonoscopy after partial colectomy remains unclear [ 17 ]. However, colonoscopy performed in 6-month intervals was occasionally insufficient to detect endoscopically resectable tumors in some patients with high risk Lynch syndrome.…”