Advertisement

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

  • Chao-Wen HsuEmail author
  • Min-Chi Chang
  • Jui-Ho Wang
  • Chih-Chien Wu
  • Yu-Hsun Chen
Original Article
  • 16 Downloads

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.

Keywords

Colorectal cancer Adhesion Stoma Laparoscopy 

Notes

Author contribution

Chao-Wen Hsu: study concept and design; acquisition of data; analysis and interpretation of data; drafting of the manuscript; statistical analysis.

Min-Chi Chang, Chih-Chien Wu, Yu-Hsun Chen: acquisition of data.

Jui-Ho Wang: critical revision of the manuscript for import and intellectual content.

Funding information

This work was supported by the Kaohsiung Veterans General Hospital, Taiwan (grant KSB108-056). This work was assisted in part by the Division of Colorectal Surgery of the Department of Surgery, Kaohsiung Veterans General Hospital.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    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):242–248CrossRefGoogle Scholar
  2. 2.
    Hershlag A, Diamond MP, DeCherney AH (1991) Adhesiolysis. Clin Obstet Gynecol 34(2):395–402CrossRefGoogle Scholar
  3. 3.
    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 9-30CrossRefGoogle Scholar
  4. 4.
    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):1247–1251CrossRefGoogle Scholar
  5. 5.
    ten Broek RP, Strik C, Issa Y, Bleichrodt RP, van Goor H (2013) Adhesiolysis-related morbidity in abdominal surgery. Ann Surg 258(1):98–106CrossRefGoogle Scholar
  6. 6.
    van Goor H (2007) Consequences and complications of peritoneal adhesions. Color Dis 9(Suppl 2):25–34CrossRefGoogle Scholar
  7. 7.
    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):1441–1444CrossRefGoogle Scholar
  8. 8.
    Wilson MS, Hawkswell J, McCloy RF (1998) Natural history of adhesional small bowel obstruction: counting the cost. Br J Surg 85(9):1294–1298CrossRefGoogle Scholar
  9. 9.
    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):1200–1207CrossRefGoogle Scholar
  10. 10.
    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 90-1CrossRefGoogle Scholar
  11. 11.
    Ward BC, Panitch A (2011) Abdominal adhesions: current and novel therapies. J Surg Res 165(1):91–111CrossRefGoogle Scholar
  12. 12.
    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):e0172088CrossRefGoogle Scholar
  13. 13.
    MAST Biosurgery USA Iiaph, wholly owned subsidiary of MAST Biosurgery AG, Switzerland. MAST Biosurgery USA, Inc. was founded in 2004 in San Diego, California http://www.mastbio.com/int/adhesion-barrier-film/. Accessed 10 Aug 2018
  14. 14.
    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):1063–1070CrossRefGoogle Scholar
  15. 15.
    Freund HR, Raniel J, Muggia-Sulam M (1982) Factors affecting the morbidity of colostomy closure: a retrospective study. Dis Colon Rectum 25(7):712–715CrossRefGoogle Scholar
  16. 16.
    Aston CM, Everett WG (1984) Comparison of early and late closure of transverse loop colostomies. Ann R Coll Surg Engl 66(5):331–333Google Scholar
  17. 17.
    Varnell J, Pemberton LB (1981) Risk factors in colostomy closure. Surgery 89(6):683–686Google Scholar
  18. 18.
    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. 1990:1009–16Google Scholar
  19. 19.
    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 15:378CrossRefGoogle Scholar
  20. 20.
    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):349–354CrossRefGoogle Scholar
  21. 21.
    Baker ML, Williams RN, Nightingale JM (2011) Causes and management of a high-output stoma. Color Dis 13(2):191–197CrossRefGoogle Scholar
  22. 22.
    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):669–676CrossRefGoogle Scholar
  23. 23.
    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):737–743CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Chao-Wen Hsu
    • 1
    • 2
    Email author
  • Min-Chi Chang
    • 1
  • Jui-Ho Wang
    • 1
  • Chih-Chien Wu
    • 1
  • Yu-Hsun Chen
    • 1
  1. 1.Division of Colorectal Surgery, Department of SurgeryKaohsiung Veteran General HospitalKaohsiungRepublic of China
  2. 2.Faculty of MedicineNational Yang-Ming UniversityTaipeiTaiwan

Personalised recommendations