PURPOSE: It is predictable that since distal gastrectomy (DG) with Billroth I anastomosis involves no procedures caudal to transverse colon, the effects of the surgical wound are the main cause of adhesive obstruction. Thus, it is an appropriate operation to test the efficiency of a synthetic absorbable adhesion barrier (Seprafilm). METHODS: The subjects were 282 patients diagnosed with gastric cancer who underwent open DG with Billroth I anastomosis between 2001 and August, 2005. Seprafilm was not used in any patients operated on before April, 2003 (n = 169), but it was used in all patients operated on from May 2003 onward (n = 113). We retrospectively compared the incidences of adhesive obstruction in the Seprafilm group and the non-Seprafilm group. RESULTS: The cumulative incidence of adhesive obstruction was significantly lower in the Seprafilm group than in the non-Seprafilm group (P = 0.021). The respective incidences of adhesive obstruction 2 years after surgery were 0.9% and 6.5%. Multivariate analysis of the occurrence of adhesive obstruction revealed no significant differences in sex, age, body mass index, operation time, blood loss, or degree of lymph-node dissection; however, it revealed a significant difference in relation to the use of Seprafilm (P = 0.049). CONCLUSION: In this series, Seprafilm reduced the incidence of adhesive obstruction after DG significantly; however, a prospective randomized study will be necessary to confirm this result.
PURPOSE: It is predictable that since distal gastrectomy (DG) with Billroth I anastomosis involves no procedures caudal to transverse colon, the effects of the surgical wound are the main cause of adhesive obstruction. Thus, it is an appropriate operation to test the efficiency of a synthetic absorbable adhesion barrier (Seprafilm). METHODS: The subjects were 282 patients diagnosed with gastric cancer who underwent open DG with Billroth I anastomosis between 2001 and August, 2005. Seprafilm was not used in any patients operated on before April, 2003 (n = 169), but it was used in all patients operated on from May 2003 onward (n = 113). We retrospectively compared the incidences of adhesive obstruction in the Seprafilm group and the non-Seprafilm group. RESULTS: The cumulative incidence of adhesive obstruction was significantly lower in the Seprafilm group than in the non-Seprafilm group (P = 0.021). The respective incidences of adhesive obstruction 2 years after surgery were 0.9% and 6.5%. Multivariate analysis of the occurrence of adhesive obstruction revealed no significant differences in sex, age, body mass index, operation time, blood loss, or degree of lymph-node dissection; however, it revealed a significant difference in relation to the use of Seprafilm (P = 0.049). CONCLUSION: In this series, Seprafilm reduced the incidence of adhesive obstruction after DG significantly; however, a prospective randomized study will be necessary to confirm this result.
Authors: Wietske W Vrijland; Larissa N L Tseng; Heert J M Eijkman; Wim C J Hop; Jack J Jakimowicz; Piet Leguit; Laurents P S Stassen; Dingeman J Swank; Robert Haverlag; H Jaap Bonjer; Hans Jeekel Journal: Ann Surg Date: 2002-02 Impact factor: 12.969
Authors: M R Salum; D T Lam; S D Wexner; A Pikarsky; M K Baig; E G Weiss; J J Nogueras; J J Singh Journal: Dis Colon Rectum Date: 2001-05 Impact factor: 4.585
Authors: Victor W Fazio; Zane Cohen; James W Fleshman; Harry van Goor; Joel J Bauer; Bruce G Wolff; Marvin Corman; Robert W Beart; Steven D Wexner; James M Becker; John R T Monson; Howard S Kaufman; David E Beck; H Randolph Bailey; Kirk A Ludwig; Michael J Stamos; Ara Darzi; Ronald Bleday; Richard Dorazio; Robert D Madoff; Lee E Smith; Susan Gearhart; Keith Lillemoe; Jonas Göhl Journal: Dis Colon Rectum Date: 2006-01 Impact factor: 4.585
Authors: Sung Geun Kim; Kyo Young Song; Han Hong Lee; Eun Young Kim; Jun Hyun Lee; Hae Myung Jeon; Kyung Hwa Jeon; Hyung Min Jin; Dong Jin Kim; Wook Kim; Han Mo Yoo; Jeong Gu Kim; Cho Hyun Park Journal: Medicine (Baltimore) Date: 2019-05 Impact factor: 1.817