Adept (icodextrin 4% solution) reduces adhesions after laparoscopic surgery for adhesiolysis: a double-blind, randomized, controlled study

Brown, C B; Luciano, Anthony A.; Dc, Martin; Peers, Elizabeth; Scrimgeour, Alison; diZerega, Gere S.

doi:10.1016/j.fertnstert.2006.12.084

Cited by 205 publications

(169 citation statements)

References 47 publications

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“…A host of substances includingCristalloid Ringer lactate, Dextran solution, 4% icodexteine solution Liquid hyaluronic acid,inter gel, Auto-cross hyaluronic acid and Sepracoat have been utilized. FDA approved the 4% icodextrin solution on the basis of head to head comparison with Ringer"sLactate 16 . Again their efficacy in C/S is not proven to be significant.…”

Section: Hydrofloatationmentioning

confidence: 99%

Prevention of Postoperative Adhesions of Caesarean Section

Nasreen

Shahreen

Huq

et al. 2017

J. Bangladesh Coll. Phys.

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Adhesions means fibrous or scar tissue that results from the healing process. Up to 95% of patients who have surgery develop adhesions. Adhesions formation and its long term sequel is a well known complication of the surgery but unfortunately very little is investigated about the prevention. The long term morbidities such as chronic pelvic pain, secondary infertility, hospital readmission, bowel obstruction, difficult repeat C/S with increased bleeding, longer operative time, injury to bowel ,bladder, ureters and placental accreta spectrum disorder from adhesions are the main concern. The cost for these adhesions is extreme burden for the developing countries.

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Section: Hydrofloatationmentioning

confidence: 99%

Prevention of Postoperative Adhesions of Caesarean Section

Nasreen

Shahreen

Huq

et al. 2017

J. Bangladesh Coll. Phys.

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“…The icodextrin functions by temporarily separating peritoneal surfaces through hydroflotation. It persists for several days in the peritoneal cavity and is slowly absorbed by the lymphatic system into the systemic circulation, where it is broken down by amylase and metabolized to glucose (11). Several experimental and clinical studies have demonstrated the efficacy of ID in reducing postsurgical adhesion formation (11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Comparison of 4% icodextrin and auto-crosslinked hyaluronic acid gel in terms of efficacy and cost effectivity in preventing postoperative abdominal adhesions

Baskonus¹,

Maralcan²,

Gökalp³

et al. 2013

Gaziantep Med J

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This experimental study was designed to compare the effects and costs of 4% icodextrin and hyaluronic acid in intraabdominal adhesion formation in rats. This study included 30 healthy Wistar albino rats, each weighing 250-300 gr. Following cecal-ileal abrasion to rats in each group, the following treatments were applied: Group 1 (control, n:10) 5 ml saline irrigation; Group 2 (n:10) 5 ml 4% icodextrin solution; Group 3 (n:10) 3 ml auto-crosslinked hyaluronic acid gel. After 14 days, following a second operation, adhesion intensity scoring, histopathological assessment (inflammation, fibrosis) and costs were compared between groups. The lowest postoperative adhesion intensity score was found in the group 3 and the highest score was found in the group 1 (p=0.028). Group 3 had a non-significantly lower adhesion intensity score than group 2 (p>0.05). In terms of inflammation and fibrosis, group 2 had the lowest score, but there were no significant differences between all the groups (p>0.05). In terms of cost, 4% icodextrin is less expensive than hyaluronic acid. The results demonstrated that both hyaluronic acid and 4% icodextrin are similarly effective in reducing postoperative intraabdominal adhesions. In addition, 4% icodextrin is more cost-effective, which can be an advantage for clinical studies.

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“…The colloidal osmotic action of this polymer retains a reservoir of fluid within the peritoneal cavity for 3-4 days, and creates a temporary physical separation between the peritoneal surfaces. This effect has been suggested to minimize surface apposition during the critical cycle of fibrin formation and reduces adherence formation (11). The individual anti-adhesive properties of Mitomycin-C and 4% Icodextrin have been assessed by several studies.…”

mentioning

confidence: 99%

Prevention of Intraabdominal Adhesions: An Experimental Study Using Mitomycin-C and 4% Icodextrin

Urkan¹,

Özerhan²,

Ünlü³

et al. 2016

Balkan Med J

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Background:Intraabdominal adhesions remain a significant cause of morbidity and mortality. Moreover, intraabdominal adhesions can develop in more than 50% of abdominal operations. Aims: We compared the anti-adhesive effects of two different agents on postoperative adhesion formation in a cecal abrasion model. Study Design: Experimental animal study. Methods: Forty Wistar albino type female rats were anesthetized and underwent laparotomy. Study groups comprised Sham, Control, Mitomycin-C, 4% Icodextrin, and Mitomycin-C +4% Icodextrin groups. Macroscopic and histopathological evaluations of adhesions were performed. Results: The frequencies of moderate and severe adhesions were significantly higher in the control group than the other groups. The mitomycin-C and Mitomycin-C +4% Icodextrin groups were associated with significantly lower adhesion scores compared to the control group and 4% Icodextrin group scores (p=0.002 and p=0.008, respectively). The adhesion scores of the Mitomycin-C group were also significantly lower than those of the 4% Icodextrin group (p=0.008). Conclusion: Despite its potential for bone marrow toxicity, Mitomycin-C seems to effectively prevent adhesions. Further studies that prove an acceptable safety profile relating to this promising anti-adhesive agent are required before moving into clinical trials.

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Adept (icodextrin 4% solution) reduces adhesions after laparoscopic surgery for adhesiolysis: a double-blind, randomized, controlled study

Cited by 205 publications

References 47 publications

Prevention of Postoperative Adhesions of Caesarean Section

Prevention of Postoperative Adhesions of Caesarean Section

Comparison of 4% icodextrin and auto-crosslinked hyaluronic acid gel in terms of efficacy and cost effectivity in preventing postoperative abdominal adhesions

Prevention of Intraabdominal Adhesions: An Experimental Study Using Mitomycin-C and 4% Icodextrin

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