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Erschienen in:

07.01.2019 | Original Article

Placement of SurgiWrap® adhesion barrier film around the protective loop stoma after laparoscopic colorectal cancer surgery may reduce the peristomal adhesion severity and facilitate the closure

verfasst von: Chao-Wen Hsu, Min-Chi Chang, Jui-Ho Wang, Chih-Chien Wu, Yu-Hsun Chen

Erschienen in: International Journal of Colorectal Disease | Ausgabe 3/2019

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Abstract

Purpose

A temporary loop stoma is often created after laparoscopic colorectal cancer surgery. Peristomal adhesions may make stoma closure into a complicated operation. We demonstrated how to place the SurgiWrap® adhesion barrier film and evaluated the peristomal adhesion severity and feasibility of stoma closure.

Methods

This is a retrospective case-control study. Patients were divided into a study group (placement of adhesion barrier film) and a control group (no placement). Patient characteristics, operative data, and severity of adhesions were recorded. We used logistic regression to probe the association between the variables and the adhesion severity.

Results

A total of 180 patients were identified with 60 in the study group and 120 in the control group. In the study group, the adhesion severity (p < 0.001), operative time (p = 0.025), and time to flatus (p = 0.042) are significantly reduced. In logistic regression analysis, placement of the film (p < 0.001), neoadjuvant concurrent chemoradiotherapy (p = 0.041), and time interval between stoma creation and closure ≧ 12 weeks (p = 0.038) are three significant factors influencing the peristomal adhesion.

Conclusion

The placement of SurgiWrap® adhesion barrier film around the loop stoma after laparoscopic colorectal cancer surgery may reduce the peristomal adhesion severity and facilitate the stoma closure in terms of operative time and time to flatus.
Literatur
1.
Zurück zum Zitat Luijendijk RW, de Lange DC, Wauters CC, Hop WC, Duron JJ, Pailler JL et al (1996) Foreign material in postoperative adhesions. Ann Surg 223(3):242–248CrossRefPubMedPubMedCentral Luijendijk RW, de Lange DC, Wauters CC, Hop WC, Duron JJ, Pailler JL et al (1996) Foreign material in postoperative adhesions. Ann Surg 223(3):242–248CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Hershlag A, Diamond MP, DeCherney AH (1991) Adhesiolysis. Clin Obstet Gynecol 34(2):395–402CrossRefPubMed Hershlag A, Diamond MP, DeCherney AH (1991) Adhesiolysis. Clin Obstet Gynecol 34(2):395–402CrossRefPubMed
3.
Zurück zum Zitat Parker MC, Ellis H, Moran BJ, Thompson JN, Wilson MS, Menzies D, McGuire A, Lower AM, Hawthorn RJS, OʼBrien F, Buchan S, Crowe AM (2001) Postoperative adhesions: ten-year follow-up of 12,584 patients undergoing lower abdominal surgery. Dis Colon Rectum 44(6):822–829 discussion 9-30CrossRefPubMed Parker MC, Ellis H, Moran BJ, Thompson JN, Wilson MS, Menzies D, McGuire A, Lower AM, Hawthorn RJS, OʼBrien F, Buchan S, Crowe AM (2001) Postoperative adhesions: ten-year follow-up of 12,584 patients undergoing lower abdominal surgery. Dis Colon Rectum 44(6):822–829 discussion 9-30CrossRefPubMed
4.
Zurück zum Zitat Swank DJ, Swank-Bordewijk SC, Hop WC, van Erp WF, Janssen IM, Bonjer HJ et al (2003) Laparoscopic adhesiolysis in patients with chronic abdominal pain: a blinded randomised controlled multi-centre trial. Lancet (London, England) 361(9365):1247–1251CrossRef Swank DJ, Swank-Bordewijk SC, Hop WC, van Erp WF, Janssen IM, Bonjer HJ et al (2003) Laparoscopic adhesiolysis in patients with chronic abdominal pain: a blinded randomised controlled multi-centre trial. Lancet (London, England) 361(9365):1247–1251CrossRef
5.
Zurück zum Zitat ten Broek RP, Strik C, Issa Y, Bleichrodt RP, van Goor H (2013) Adhesiolysis-related morbidity in abdominal surgery. Ann Surg 258(1):98–106CrossRefPubMed ten Broek RP, Strik C, Issa Y, Bleichrodt RP, van Goor H (2013) Adhesiolysis-related morbidity in abdominal surgery. Ann Surg 258(1):98–106CrossRefPubMed
6.
Zurück zum Zitat van Goor H (2007) Consequences and complications of peritoneal adhesions. Color Dis 9(Suppl 2):25–34CrossRef van Goor H (2007) Consequences and complications of peritoneal adhesions. Color Dis 9(Suppl 2):25–34CrossRef
7.
Zurück zum Zitat Kossi J, Salminen P, Rantala A, Laato M (2003) Population-based study of the surgical workload and economic impact of bowel obstruction caused by postoperative adhesions. Br J Surg 90(11):1441–1444CrossRefPubMed Kossi J, Salminen P, Rantala A, Laato M (2003) Population-based study of the surgical workload and economic impact of bowel obstruction caused by postoperative adhesions. Br J Surg 90(11):1441–1444CrossRefPubMed
8.
Zurück zum Zitat Wilson MS, Hawkswell J, McCloy RF (1998) Natural history of adhesional small bowel obstruction: counting the cost. Br J Surg 85(9):1294–1298CrossRefPubMed Wilson MS, Hawkswell J, McCloy RF (1998) Natural history of adhesional small bowel obstruction: counting the cost. Br J Surg 85(9):1294–1298CrossRefPubMed
9.
Zurück zum Zitat Tang CL, Seow-Choen F, Fook-Chong S, Eu KW (2003) Bioresorbable adhesion barrier facilitates early closure of the defunctioning ileostomy after rectal excision: a prospective, randomized trial. Dis Colon Rectum 46(9):1200–1207CrossRefPubMed Tang CL, Seow-Choen F, Fook-Chong S, Eu KW (2003) Bioresorbable adhesion barrier facilitates early closure of the defunctioning ileostomy after rectal excision: a prospective, randomized trial. Dis Colon Rectum 46(9):1200–1207CrossRefPubMed
10.
Zurück zum Zitat Salum M, Wexner SD, Nogueras JJ, Weiss E, Koruda M, Behrens K et al (2006) Does sodium hyaluronate- and carboxymethylcellulose-based bioresorbable membrane (Seprafilm) decrease operative time for loop ileostomy closure? Tech Coloproctol 10(3):187–190 discussion 90-1CrossRefPubMed Salum M, Wexner SD, Nogueras JJ, Weiss E, Koruda M, Behrens K et al (2006) Does sodium hyaluronate- and carboxymethylcellulose-based bioresorbable membrane (Seprafilm) decrease operative time for loop ileostomy closure? Tech Coloproctol 10(3):187–190 discussion 90-1CrossRefPubMed
11.
Zurück zum Zitat Ward BC, Panitch A (2011) Abdominal adhesions: current and novel therapies. J Surg Res 165(1):91–111CrossRefPubMed Ward BC, Panitch A (2011) Abdominal adhesions: current and novel therapies. J Surg Res 165(1):91–111CrossRefPubMed
12.
Zurück zum Zitat Lin LX, Yuan F, Zhang HH, Liao NN, Luo JW, Sun YL (2017) Evaluation of surgical anti-adhesion products to reduce postsurgical intra-abdominal adhesion formation in a rat model. PLoS One 12(2):e0172088CrossRefPubMedPubMedCentral Lin LX, Yuan F, Zhang HH, Liao NN, Luo JW, Sun YL (2017) Evaluation of surgical anti-adhesion products to reduce postsurgical intra-abdominal adhesion formation in a rat model. PLoS One 12(2):e0172088CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Van Leersum NJ, Snijders HS, Henneman D, Kolfschoten NE, Gooiker GA, ten Berge MG et al (2013) The Dutch surgical colorectal audit. Eur J Surg Oncol 39(10):1063–1070CrossRefPubMed Van Leersum NJ, Snijders HS, Henneman D, Kolfschoten NE, Gooiker GA, ten Berge MG et al (2013) The Dutch surgical colorectal audit. Eur J Surg Oncol 39(10):1063–1070CrossRefPubMed
15.
Zurück zum Zitat Freund HR, Raniel J, Muggia-Sulam M (1982) Factors affecting the morbidity of colostomy closure: a retrospective study. Dis Colon Rectum 25(7):712–715CrossRefPubMed Freund HR, Raniel J, Muggia-Sulam M (1982) Factors affecting the morbidity of colostomy closure: a retrospective study. Dis Colon Rectum 25(7):712–715CrossRefPubMed
16.
Zurück zum Zitat Aston CM, Everett WG (1984) Comparison of early and late closure of transverse loop colostomies. Ann R Coll Surg Engl 66(5):331–333PubMedPubMedCentral Aston CM, Everett WG (1984) Comparison of early and late closure of transverse loop colostomies. Ann R Coll Surg Engl 66(5):331–333PubMedPubMedCentral
17.
Zurück zum Zitat Varnell J, Pemberton LB (1981) Risk factors in colostomy closure. Surgery 89(6):683–686PubMed Varnell J, Pemberton LB (1981) Risk factors in colostomy closure. Surgery 89(6):683–686PubMed
18.
Zurück zum Zitat Zuhlke HV, Lorenz EM, Straub EM, Savvas V. [Pathophysiology and classification of adhesions]. Langenbecks Archiv fur Chirurgie Supplement II, Verhandlungen der Deutschen Gesellschaft fur Chirurgie Deutsche Gesellschaft fur Chirurgie Kongress. 1990:1009–16 Zuhlke HV, Lorenz EM, Straub EM, Savvas V. [Pathophysiology and classification of adhesions]. Langenbecks Archiv fur Chirurgie Supplement II, Verhandlungen der Deutschen Gesellschaft fur Chirurgie Deutsche Gesellschaft fur Chirurgie Kongress. 1990:1009–16
19.
Zurück zum Zitat Stommel MW, Strik C, ten Broek RP, van Goor H (2014) Efficacy and safety of the C-Qur film adhesion barrier for the prevention of surgical adhesions (CLIPEUS trial): study protocol for a randomized controlled trial. Trials 15:378CrossRefPubMedPubMedCentral Stommel MW, Strik C, ten Broek RP, van Goor H (2014) Efficacy and safety of the C-Qur film adhesion barrier for the prevention of surgical adhesions (CLIPEUS trial): study protocol for a randomized controlled trial. Trials 15:378CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Wexner SD, Taranow DA, Johansen OB, Itzkowitz F, Daniel N, Nogueras JJ, Jagelman DG (1993) Loop ileostomy is a safe option for fecal diversion. Dis Colon Rectum 36(4):349–354CrossRefPubMed Wexner SD, Taranow DA, Johansen OB, Itzkowitz F, Daniel N, Nogueras JJ, Jagelman DG (1993) Loop ileostomy is a safe option for fecal diversion. Dis Colon Rectum 36(4):349–354CrossRefPubMed
21.
Zurück zum Zitat Baker ML, Williams RN, Nightingale JM (2011) Causes and management of a high-output stoma. Color Dis 13(2):191–197CrossRef Baker ML, Williams RN, Nightingale JM (2011) Causes and management of a high-output stoma. Color Dis 13(2):191–197CrossRef
22.
Zurück zum Zitat Tytgat GN, Huibregtse K, Dagevos J, van den Ende A (1977) Effect of loperamide on fecal output and composition in well-established ileostomy and ileorectal anastomosis. Am J Dig Dis 22(8):669–676CrossRefPubMed Tytgat GN, Huibregtse K, Dagevos J, van den Ende A (1977) Effect of loperamide on fecal output and composition in well-established ileostomy and ileorectal anastomosis. Am J Dig Dis 22(8):669–676CrossRefPubMed
23.
Zurück zum Zitat McBride WH, Mason KA, Davis C, Withers HR, Smathers JB (1989) Adhesion formation in experimental chronic radiation enteropathy. Int J Radiat Oncol Biol Phys 16(3):737–743CrossRefPubMed McBride WH, Mason KA, Davis C, Withers HR, Smathers JB (1989) Adhesion formation in experimental chronic radiation enteropathy. Int J Radiat Oncol Biol Phys 16(3):737–743CrossRefPubMed
Metadaten
Titel
Placement of SurgiWrap® adhesion barrier film around the protective loop stoma after laparoscopic colorectal cancer surgery may reduce the peristomal adhesion severity and facilitate the closure
verfasst von
Chao-Wen Hsu
Min-Chi Chang
Jui-Ho Wang
Chih-Chien Wu
Yu-Hsun Chen
Publikationsdatum
07.01.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
International Journal of Colorectal Disease / Ausgabe 3/2019
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-018-03229-3

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