Shoichi Fujii, MD, PhD1, Mitsuo Tsukamoto2, Yoshihisa Fukushima2, Ryu Shimada2, Koichi Okamoto2, Tamuro Hayama2, Takeshi Tsuchiya2, Keijiro Nozawa2, Keiji Matsuda2, Yojiro Hashiguchi2. 1International University of Health and Welfare, 2Teikyo University
Background: A protective efficacy by absorptive adhesion prevention product (Seprafilm®) to bowel obstruction (BO) was proven from large-scale RCT of Europe and America in the open surgery. However, it is uncertain in the laparoscopic surgery.
Purpose: To clarify a protective efficacy by Seprafilm against BO after laparoscopic surgery for colorectal cancer
Methods: From 2006 to 2015, 731 laparoscopic colorectal resections were performed for colorectal cancer. Incidence of BO and short-term results were compared between Seprafilm and Non-Seprafilm group. And, risk factors for BO were retrospectively analyzed.
Results: A total of 546 patients were in Seprafilm group and 185 patients were in Non-Seprafilm group. There were significant differences in age and pathological stage. Seprafilm group was significantly lower than Non-Seprafilm group in grade 2 or more of BO (2.9% vs. 11.4%). There was no difference in grade 3 or more of BO (2.4% vs. 4.3%). There were significant differences in BO within 30 days (2.0% vs. 9.2%) and BO after 30 days (0.9% vs. 3.2%). Incidence of surgical site infection was higher in Non-Seprafilm group (3.1% vs. 10.3%). There was no significant difference in anastomotic leakage between both groups. ASA 2 or more, stoma creation procedure, and non-using of Seprafilm were indicated as a risk factor by the multivariable analysis.
Conclusion: Seprafilm was useful for prevention of BO in laparoscopic colorectal surgery without increasing adverse event. Seprafilm is especially recommended in laparoscopic colorectal surgery, in stoma creation procedure and operation for high ASA patient.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79617
Program Number: P250
Presentation Session: Poster (Non CME)
Presentation Type: Poster
