Direct comparison of Seprafilm(A (R)) versus Adept(A (R)) versus no additive for reducing the risk of small-bowel obstruction in colorectal cancer surgery

Abstract

To assess the effectiveness of using sodium hyaluronate-based bioresorbable membrane (Seprafilm(A (R))) versus 4 % icodextrin solution (Adept(A (R))) versus no additive intraoperatively and to prevent postoperative small-bowel obstruction in patients undergoing colorectal cancer (CRC) surgery. The subjects of this retrospective study were 454 patients, who underwent CRC surgery between February 2007 and January 2010. Among the 454 enrolled patients, 114 patients received Seprafilm(A (R)), 180 patients received Adept(A (R)), and 160 patients received no additive, based on the year of their surgery. The overall incidences of small-bowel obstruction were 8.8, 4.3, and 6.9 %, for the Adept(A (R)), Seprafilm(A (R)), and no additive (control) groups, respectively. The cumulative incidence was significantly higher in the Adept(A (R)) group than in the Seprafilm(A (R)) and control groups (Adept(A (R)) vs. Seprafilm(A (R)), P = 0.043; Adept(A (R)) vs. control group, P = 0.002). No significant difference was found between the Seprafilm group and the control group (P = 0.549). Adept(A (R)) solution and Seprafilm(A (R)) did not alter the liver and renal function, as assessed by blood chemistry. The use of Adept(A (R)) significantly increased the incidence of small-bowel obstruction in patients undergoing CRC surgery.