A new treatment for retroperitoneal fibrosis: initial experiences of using Seprafilm^® to wrap the ureter

Abstract

Objective To confirm the efficacy of using Seprafilm® (Genzyme Corp., Cambridge, MA, USA) for wrapping the ureter to treat the ureteric stenosis caused by retroperitoneal fibrosis (RPF). Patients and Methods Between August 2010 and September 2012, 11 ureters in eight patients with RPF (seven males and one female, mean age 65 years) were treated. The mean (range) length of the narrow segment of the ureter was 30 (10–90) mm. During surgery, after having been released from adhesive tissue, the stenotic segment of the ureter was wrapped with Seprafilm to isolate it from the surrounding tissue. A radiographic follow‐up was performed every 6 months using computed tomography, i.v. pyelography and/or 99mTc‐mercapto‐acetylglycyl‐glycyl‐glycine (99mTc‐MAG3) renal scintigraphy. Results For the unilateral operations, the mean estimated blood loss was 39 mL, and the mean operating time was 154 min. All ureters were isolated from the fibrotic tissue and wrapped with Seprafilm successfully without major complications. During the mean follow‐up period of 17 months, no ureteric restenoses were observed in the affected sides, but new stenosis occurred in the contralateral side of the ureter in one patient. Conclusions Although the follow‐up period is still limited, we believe that the use of Seprafilm has the potential to become an effective option in the treatment of ureteric stenosis caused by RPF, when the omentum cannot be used. To establish the relative advantages of using Seprafilm over performing a standard omental wrap, further experimentation will be required to compare the two techniques.

Fouling-resistant zwitterionic polymers for complete prevention of postoperative adhesion

“…Furthermore, Interceed requires meticulous hemostasis during the application (22), which is impractical during a surgery. Seprafilm can easily adhere to any moist surface, including the surgeon's gloves, during the placement, causing inconvenience, reposition issues, and even failure (23). Infusing polymer solutions such as liters of Adept (icodextrin 4% solution) were found to overcome the disadvantages of film products to some extent, but their applications are in general very limited due to the short dwelling time in the abdominal cavity (24,25).…”

Rapidly Self-Deactivating and Injectable Succinyl Ester-Based Bioadhesives for Postoperative Antiadhesion

“…Very few materials were developed to prevent the adhesion of the liver. Commercial products such as Interceed (oxidized regenerated cellulose) and Seprafilm (hyaluronate carboxymethylcellulose) did not perform well in preventing adhesion formation after liver injury. ,, To test if the SEgel could effectively reduce the liver adhesion, experiments were carried out on the liver adhesion model of SD rats. The SD rat liver is made up of four lobes, including the caudate lobe (CL), medial lobe (ML), right lateral lobe (RLL), and left lateral lobe (LLL).…”

Adhesive Nanoparticle‐in‐Microgel System with ROS Scavenging Capability and Hemostatic Activity for Postoperative Adhesion Prevention

“…The microgels were sterilized by resuspension in 75% ethanol overnight, and washed twice with PBS before use. HUVECs were seeded in 96‐well plates (1×10 4 cells well −1 ) and cultured at 37°C for 1 d, followed by adding microgels at concentrations of 50 µg mL −1 . After 24 h incubation, the viability of the cells was determined using CCK8 assay.…”

“…[ 3 ] However, solid films barriers, such as Interceed (consists of oxidized regenerated cellulose) and Seprafilm (consists of sodium hyaluronate and carboxymethyl cellulose), are inconvenient to use in practice. [ 4 ] Adept (4% icodextrin), a polymer solution infused into the abdomen, has suffered from low efficacy due to its short dwelling time and unstable fixation. [ 5 ]…”