Reduction in adhesive small-bowel obstruction by Seprafilm® adhesion barrier after intestinal resection

Fazio, Victor W., Cohen, Zane, Fleshman, James W., van Goor, Harry, Bauer, Joel J., Wolff, Bruce G., Corman, Marvin, Beart, Robert W., Wexner, Steven D., Becker, James M., Monson, John R. T., Kaufman, Howard S., Beck, David E., Bailey, H. Randolph, Ludwig, Kirk A., Stamos, Michael J., Darzi, Ara, Bleday, Ronald, Dorazio, Richard, Madoff, Robert D., Smith, Lee E., Gearhart, Susan, Lillemoe, Keith and Gohl, Jonas (2006) Reduction in adhesive small-bowel obstruction by Seprafilm® adhesion barrier after intestinal resection. Diseases of the Colon and Rectum, 49 1: 1-11. doi:10.1007/s10350-005-0268-5


Author Fazio, Victor W.
Cohen, Zane
Fleshman, James W.
van Goor, Harry
Bauer, Joel J.
Wolff, Bruce G.
Corman, Marvin
Beart, Robert W.
Wexner, Steven D.
Becker, James M.
Monson, John R. T.
Kaufman, Howard S.
Beck, David E.
Bailey, H. Randolph
Ludwig, Kirk A.
Stamos, Michael J.
Darzi, Ara
Bleday, Ronald
Dorazio, Richard
Madoff, Robert D.
Smith, Lee E.
Gearhart, Susan
Lillemoe, Keith
Gohl, Jonas
Title Reduction in adhesive small-bowel obstruction by Seprafilm® adhesion barrier after intestinal resection
Formatted title
Reduction in adhesive small-bowel obstruction by Seprafilm® adhesion barrier after intestinal resection
Journal name Diseases of the Colon and Rectum   Check publisher's open access policy
ISSN 0012-3706
1530-0358
Publication date 2006-01
Sub-type Article (original research)
DOI 10.1007/s10350-005-0268-5
Volume 49
Issue 1
Start page 1
End page 11
Total pages 11
Place of publication New York, United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
INTRODUCTION: Although Seprafilm® has been demonstrated to reduce adhesion formation, it is not known whether its usage would translate into a reduction in adhesive small-bowel obstruction. METHODS: This was a prospective, randomized, multicenter, multinational, single-blind, controlled study. This report focuses on those patients who underwent intestinal resection (n = 1,701). Before closure of the abdomen, patients were randomized to receive Seprafilm® or no treatment. Seprafilm® was applied to adhesiogenic tissues throughout the abdomen. The incidence and type of bowel obstruction was compared between the two groups. Time to first adhesive small-bowel obstruction was compared during the course of the study by using survival analysis methods. The mean follow-up time for the occurrence of adhesive small-bowel obstruction was 3.5 years. RESULTS: There was no difference between the treatment and control group in overall rate of bowel obstruction. The incidence of adhesive small-bowel obstruction requiring reoperation was significantly lower for Seprafilm® patients compared with no-treatment patients: 1.8 vs. 3.4 percent (P < 0.05). This finding represents an absolute reduction in adhesive small-bowel obstruction requiring reoperation of 1.6 percent and a relative reduction of 47 percent. In addition, a stepwise multivariate analysis indicated that the use of Seprafilm ® was the only predictive factor for reducing adhesive small-bowel obstruction requiring reoperation. In both groups, 50 percent of first adhesive small-bowel obstruction episodes occurred within 6 months after the initial surgery with nearly 30 percent occurring within the first 30 days. Additionally no first adhesive small-bowel obstruction events were reported in Years 4 and 5 of follow-up. CONCLUSIONS: The overall bowel obstruction rate was unchanged; however, adhesive small-bowel obstruction requiring reoperation was significantly reduced by the use of Seprafilm®, which was the only factor that predicted this outcome.
Keyword Seprafilm®
Adhesive small-bowel obstruction
Adhesion formation
Abdominal surgery
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Mon, 14 Mar 2011, 08:47:30 EST