Is liquid-based hyaluronic acid equivalent to sodium hyaluronate-based bioresorbable membrane to reduce small bowel obstruction in patients undergoing colorectal surgery

Abstract

Objective: We performed a prospective randomized study to assess whether the use of sodium hyaluronate-based bioresorbable membrane (Seprafilm (R)) and liquid-based hyaluronic acid and carboxymethyl cellulose solution (Guardix) to reduce postoperative small bowel small bowel obstruction in patients undergoing colorectal surgery. This study aimed to compare the incidence of postoperative bowel obstruction. Methods: One hundred seven patients were assigned to the Seprafilm (R) group and 155 were assigned to the Guardix (R) group during the study period. The control group of 166 patients received no anti-adhesive. Patients were randomly assigned. Results: The overall small bowel obstruction rate was 7.6% (N = 37/488 patients). Small bowel obstruction developed in 9 patients (5.8%) in the Guardix (R) group and 9 patients (7.1%) in the Seprafilm (R) group and 19 patients (11.4%) in the control group. Seprafilm (R) group had significantly lower obstruction rate as compared to control group (P = 0.036). Guardix (R) solution and Seprafilm (R) did not alter the liver and renal function, as assessed by the blood chemistry. Conclusions: The use of Seprafilm significantly reduces the incidence of postoperative small bowel obstruction in patients undergoing colorectal surgery. We observed no difference in the incidence of postoperative small bowel obstruction after the application of Seprafilm (R) and Guardix (R) in patients undergoing colorectal surgery. (C) 2018 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V.