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使用SprayShield™粘连屏障系统预防腹部粘连的初步研究。

Preliminary study with SprayShield™ Adhesion Barrier System in the prevention of abdominal adhesions.

作者信息

Banasiewicz Tomasz, Horbacka Karolina, Karoń Jacek, Malinger Stanisław, Antos Frantisek, Rudzki Sławomir, Kala Zdenek, Stojcev Zoran, Kössi Jyrki, Krokowicz Piotr

机构信息

Department of General Surgery, Gastroenterological Oncological Surgery and Plastic Surgery, Poznan University of Medical Sciences, Poznan, Poland.

Department of General and Colorectal Surgery, Poznan University of Medical Sciences, Poznan, Poland.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2013 Dec;8(4):301-9. doi: 10.5114/wiitm.2011.34884. Epub 2013 May 6.

Abstract

INTRODUCTION

Peritoneal adhesions, the fibrotic bands that form between the surfaces in the peritoneal cavity following surgery, still pose a difficult clinical challenge.

AIM

To evaluate the SprayShield™ Adhesion Barrier System (PEG ester amine solution and a buffer solution) in reducing post-operative adhesion formation.

MATERIAL AND METHODS

This was a prospective, multi-center, randomized, single blind study. A total of 11 subjects diagnosed with ulcerative colitis (UC) or familial adenomatous polyposis (FAP) were randomized: 8 to the SprayShield™ arm and 3 to the control arm. SprayShield™ was applied on the viscera directly under the midline peritoneal incision and at the site of ileostomy. During the follow-up surgery, the incidence, extent, and severity of post-operative adhesion formation were evaluated, as well as the time required to mobilize the ileal loop.

RESULTS

In patients who received SprayShield™ the time required to mobilize the ileal loop at the ileostomy closure was slightly shorter and the incidence and severity of adhesions were somewhat lower vs. control subjects (NS).

CONCLUSIONS

SprayShield™ was found to be easy to use, safe, and quick to apply, and performed well in adherence and conformity. The incidence and severity of adhesions were lower for SprayShield™ subjects vs. control subjects, but due to the limited number of patients there are not enough data to confirm the effectiveness of the SprayShield™ Adhesion Barrier System in prevention of adhesions.

摘要

引言

腹膜粘连是手术后腹膜腔内表面之间形成的纤维化带,仍然是一个棘手的临床挑战。

目的

评估SprayShield™粘连屏障系统(聚乙二醇酯胺溶液和缓冲溶液)在减少术后粘连形成方面的效果。

材料与方法

这是一项前瞻性、多中心、随机、单盲研究。共有11名被诊断为溃疡性结肠炎(UC)或家族性腺瘤性息肉病(FAP)的受试者被随机分组:8人进入SprayShield™组,3人进入对照组。SprayShield™直接应用于中线腹膜切口下方的内脏以及回肠造口部位。在后续手术中,评估术后粘连形成的发生率、范围和严重程度,以及游离回肠袢所需的时间。

结果

与对照组相比,接受SprayShield™的患者在回肠造口关闭时游离回肠袢所需的时间略短,粘连的发生率和严重程度也略低(无统计学意义)。

结论

发现SprayShield™易于使用、安全且应用迅速,在粘附性和贴合性方面表现良好。与对照组相比,SprayShield™组患者粘连的发生率和严重程度较低,但由于患者数量有限,没有足够的数据来证实SprayShield™粘连屏障系统在预防粘连方面的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/812f/3908634/2bcadab05b45/WIITM-8-20711-g001.jpg

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