Fewer Intraperitoneal Adhesions With Use of Hyaluronic Acid–Carboxymethylcellulose Membrane

Vrijland, W. W.; Tseng, L. N. L.; Eijkman, Heert J. M.; Hop, Wim C. J.; Jakimowicz, Jack J.; Leguit, P; Stassen, Laurents P. S.; Swank, Dingeman J.; Haverlag, Robert; Bonjer, H. Jaap; Jeekel, Hans

doi:10.1097/00000658-200202000-00006

Cited by 235 publications

(148 citation statements)

References 12 publications

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“…Whilst these preparations have been shown to reduce the extent of adhesions, 24 the translation to clinical practice has been less convincing. In a large, randomised, multicentre trial comparing the use of a hyaluronate methylcellulose membrane against a control group, no difference in the overall bowel obstruction rate was seen.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Follow-Up of the Use of the Jones' Intestinal Tube in Adhesive Small Bowel Obstruction

Fazel

Jamieson

2009

annals

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INTRODUCTION Intestinal intubation with a Jones' tube has been suggested to reduce the incidence of recurrent adhesive bstruction. This paper describes our experience of this technique. PATIENTS AND METHODS A retrospective case-note review was performed on 68 patients admitted to a teaching hospital who re identified as having had the Jones' intestinal tube placed over an 11-year period from 1980 to 1991, with a follow-up to 2003. The indication for placement and outcome following placement of the tube were documented with particular reference to recurrence of adhesive small bowel obstruction. RESULTS Data on 63 patients were available. Of these, 7 had the Jones' tube placed prophylactically after pouch surgery and re thus excluded from the main study. Of the remaining 56 patients, all had the Jones' tube placed for recurrent adhesive small bowel obstruction with a median follow-up of 92 months, representing 353 patient-years. In 51 patients, the Jones' tube was placed during emergency surgery, while five others had it placed electively. A total of 1.7 cases of adhesive small bowel obstruction per 100 years of patient follow-up were identified following use of the Jones' tube compared to 12.9 cases per 100 patient-years prior to the use of the Jones' tube. CONCLUSION Intestinal intubation with a Jones' tube is a safe and effective method of preventing recurrent adhesive obstruction.

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Section: Discussionmentioning

confidence: 99%

Long-Term Follow-Up of the Use of the Jones' Intestinal Tube in Adhesive Small Bowel Obstruction

Fazel

Jamieson

2009

annals

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“…5,6 Hyaluronic acid-carboxymethylcellulose (HACM) adhesion barrier has been shown to effectively reduce postoperative adhesions in abdominopelvic surgery. 7,8 The mechanism of action is the physical separation of traumatized and inflammatory adhesiogenic tissues and organs while normal tissue repair takes place. In terms of safety, the compound begins to break down in 7 days, well after the acute phase of normal tissue repair is finished, and is completely resorbed by the body in 28 days.…”

Section: Introductionmentioning

confidence: 99%

Use of a Hyaluronic Acid-Carboxymethylcellulose Adhesion Barrier on the Neurovascular Bundle and Prostatic Bed to Facilitate Earlier Recovery of Erectile Function After Robot-Assisted Prostatectomy: An Initial Experience

Joung

Singer³

et al. 2013

Journal of Endourology

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Purpose: To investigate the efficacy of hyaluronic acid-carboxymethylcellulose (HACM) in facilitating early recovery of erectile function (EF) after radical prostatectomy, we report our initial experience of HACM use on the neurovascular bundle (NVB) after robot-assisted radical prostatectomy (RARP). Patients and Methods: Between 2008 and 2010, 459 consecutive patients who underwent RARP with bilateral nerve-sparing technique were included in this study. Patients were classified into two groups: HACM (group 1; n = 162) and non-HACM (group 2; n = 287). HACM was delivered to the anatomic location of the NVB after prostate removal. We retrospectively analyzed the surgical outcomes including EF, continence, and perioperative complications. Results: At 6 months after surgery, EF recovery rate was 28.5% in group 1 and 17.4% in group 2 (P = 0.006). In a subgroup analysis consisting of 225 patients with a preoperative International Index of Erectile Function Short Survey (IIEF)-5 score ‡ 20, the difference in EF recovery at 6 months was significant with 62.8% in group 1 and 27.0% in group 2 (P = 0.002), respectively. HACM use was an independent predictor for EF recovery at 6 months after surgery (odds ratio, 2.735; 95% confidence interval, 1.613-4.638; P < 0.001). Age and preoperative IIEF-5 were also independent predictors. No differences in continence at 6 months or perioperative complications were found between the two groups. EF recovery was not different between the two groups after 18 months. Conclusions: HACM use around the NVBs is safe and facilitates early recovery of EF after nerve-sparing RARP. HACM use is more effective in patients with normal preoperative sexual function.

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“…Actually there is no widely agreed consensus on preventing adhesion formation except intraoperative preventive measures such as reducing retained surgical material, meticulous hemostasis, avoiding excessive dissection, and ischemia. Protection of wounded surfaces with various materials had been proposed to overcome this condition, including absorbable patches [9], gels [10], or some liquids such as icodextrin [11]. All three types of adhesion barriers have limited approval by the United States Food and Drug Administration [6,12].…”

Section: Discussionmentioning

confidence: 99%

Comparison of 4 % Icodextrin and Omega 3 Fatty Acids in Prevention of Peritoneal Adhesions

Karakaş¹,

Yigitler

Güleç

et al. 2012

Indian J Surg

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Postoperative peritoneal adhesions are major concerns in abdominal surgery. In this experimental study, the effects of 4 % icodextrin and omega-3 fatty acids (ω-3 FA) on prevention of postoperative peritoneal adhesions were evaluated. Twenty-four Wistar albino rats were divided into three groups. After laparotomy, serosal abrasion was carried out by cecal brushing. Intraperitoneally 3 cm 3 0.9 % NaCl, 3 cm 3 4 % icodextrin, and 200 mg/kg ω-3 FAs for each group were applied, and then the abdomen was closed. All subjects sacrificed 10 days postoperatively. Macroscopic and histopathological cellular reactions as a function of giant cell, lymphocyte/plasmocyte, neutrophil, histiocyte, intracellular adhesion molecule-1 (ICAM-1), and platelet endothelial cell adhesion molecule-1 (PECAM-1) were assessed and hydroxyproline levels were measured in all three groups and compared using Kruskal-Wallis and ANOVA tests when appropriate. Macroscopically, both ω-3 FAs and 4 % icodextrin reduced adhesion formation but the difference was not statistically significant (P00.253). Histopathological examination revealed that there was no statistical significance in terms of giant cell, lymphocyte/plasmocyte, neutrophil, ICAM-1, and PECAM-1 scores; however, both ω-3 FAs and 4 % icodextrin were found to be prone to reduce fibrosis (P00.047), whereas in the ω-3 FA group, histiocytic reaction was significantly increased (P00.001), and hydroxyproline levels were significantly lower than other groups (P00.044). In this study, ω-3 FAs were found to be superior to 4 % icodextrin with the lower hydroxyproline level and greater histiocytic reaction. Considering these results, ω-3 FAs can be a promising agent in the prevention of adhesion formation.

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Fewer Intraperitoneal Adhesions With Use of Hyaluronic Acid–Carboxymethylcellulose Membrane

Cited by 235 publications

References 12 publications

Long-Term Follow-Up of the Use of the Jones' Intestinal Tube in Adhesive Small Bowel Obstruction

Long-Term Follow-Up of the Use of the Jones' Intestinal Tube in Adhesive Small Bowel Obstruction

Use of a Hyaluronic Acid-Carboxymethylcellulose Adhesion Barrier on the Neurovascular Bundle and Prostatic Bed to Facilitate Earlier Recovery of Erectile Function After Robot-Assisted Prostatectomy: An Initial Experience

Comparison of 4 % Icodextrin and Omega 3 Fatty Acids in Prevention of Peritoneal Adhesions

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