Preventive effects of a synthetic absorbable antiadhesive film (seprafilm) on small bowel obstruction in patients who underwent elective surgery for colon cancer: A randomized controlled trial

Abstract

Background Seprafilm did not decrease small bowel obstruction (SBO), but significantly decreased reoperation in patients with inflammatory bowel disease. However, the preventive effect in colon cancer remains unclear. Methods We conducted a randomized controlled trial in patients with colon cancer. The study group comprised 345 patients with colon cancer. In the seprafilm group (n = 166), two sheets of seprafilm were inserted under a midline incision. Patients who were admitted and required decompression were considered to have SBO. Results The median follow‐up was 61.9 months. Patient characteristics were well balanced. There was no significant difference in the incidence of SBO between the seprafilm group (7.8%) and the control group (10.6%) (P = .46). In patients who underwent reoperation, SBO occurred in a midline incision in one patient and at other sites in four patients in the seprafilm group as compared with two patients and five patients, respectively, in the control group. Multivariate analysis showed that only a history of laparotomy was an independent risk factor for SBO. Conclusions Seprafilm did not decrease SBO or reoperation in colon cancer. The incidence of SBO caused by adhesion to the midline incision was relatively low as compared with that caused by adhesion to other sites.

Oxidized Regenerated Cellulose Sheets in Postoperative Intrathoracic Adhesions

“…There are some reports about the use of adhesion barriers in abdominal surgery, and several types of adhesion barriers, including ORC sheets, are often used. [4][5][6] The ORC sheet is placed to cover the surgical site. It swells and eventually gels to form a barrier that protects it from adhesion, and it is slowly absorbed by hydrolysis within 28 days.…”

Effect of sodium hyaluronate-arboxycellulose membrane (Seprafilm®) on postoperative small bowel obstruction: A meta-analysis

“…For example, Saito et al found a significant effect of Seprafilm ® on reducing the rate of reoperation. 10 Thus, the other benefits of Seprafilm ® should be investigated in future studies.…”

“…For example, Saito et al found that Seprafilm ® did not decrease the rate of small bowel obstruction in patients operated on for colon cancer. 10 In contrast, Lee et al demonstrated a significant effect of Seprafilm ® in reducing the incidence of postoperative small bowel obstruction in patients undergoing colorectal surgery. 11 The contradictions among these studies may be caused by differences in study design, sample size, study region, and so on.…”

A Trial Protocol to Investigate the Incidence of Postoperative Bowel Obstruction after Laparoscopic Colorectal Cancer Surgery Using an Absorbable Adhesion Barrier Material (INTERCEED^®) (Balsam CEED Study): A Prospective, Multicenter, Observational Study

“…A systematic review and metaanalysis concluded that hyaluronate-carboxymethylcellulose membranes (Seprafilm Ⓡ ) can decrease abdominal adhesions but cannot reduce postoperative SBO after general surgery [3]. Furthermore, a single-center, randomized control trial involving open colon cancer surgery showed that Seprafilm Ⓡ does not reduce postoperative SBO after open colon cancer surgery (Seprafilm group vs control group: 7.8% vs 10%, p = 0.46) [4]. Suto et al conducted a prospective, randomized, single-blind study in patients who underwent laparotomy with ileostomy to clarify whether Adspray Ⓡ , a newly developed spray-type APB, reduce the incidence of adhesion after open rectal anterior resection with ileostomy [5].…”