Efficacy and Safety of Seprafilm for Preventing Postoperative Abdominal Adhesion: Systematic Review and Meta-analysis |
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Authors: | Qiqiang Zeng Zhengping Yu Jie You Qiyu Zhang |
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Institution: | (1) Department of General Surgery, the First Affiliated Hospital, Wenzhou Medical College, Wenzhou, 325003, Zhejiang Province, China;(2) Department of Oncological Surgery, the First Affiliated Hospital, Wenzhou Medical College, Wenzhou, 325003, Zhejiang Province, China |
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Abstract: | Background There is no clear consensus on the efficacy and safety of hyaluronate-carboxymethylcellulose membrane (Seprafilm) for preventing
postoperative abdominal adhesion. This study is a meta-analysis of the available evidence.
Methods A search of the MEDLINE, EMBASE, and the Cochrane Library identified eight studies that met the inclusion criteria for data
extraction. Estimates of effectiveness were performed using fixed- and random-effects models. The effect was calculated as
an odds ratio (OR) with 95% confidence intervals (CI) using the statistical software Review Manager Version 4.2. Level of
significance was set at p < 0.05.
Results Outcomes of 4203 patients were studied. The incidence of grade 0 adhesions among Seprafilm-treated patients was statistically
significantly more than that observed among control group patients (OR 95%CI, 3.74–20.34; p < 0.01). There was no significant difference in the incidence of grade 1 adhesions between Seprafilm and control groups (OR
95%CI, 0.58–2.71; p = 0.56). The severity of grade 2 and grade 3 adhesions among Seprafilm-treated patients was significantly less than that
observed among control group patients (OR 95%CI, 0.22–0.93; p = 0.03; OR 95%CI, 0.09–0.63; p < 0.01, respectively). The incidence of intestinal obstruction after abdominal surgery was not different between Seprafilm
and control groups (OR 95%CI, 0.78–1.23; p = 0.84). Using Seprafilm significantly increased the incidence of abdominal abscesses (OR 95%CI, 1.06–2.54; p = 0.03) and anastomotic leaks (OR 95%CI, 1.18–3.50; p = 0.01).
Conclusions Our systematic review and meta-analysis showed that Seprafilm could decrease abdominal adhesions after general surgery, which
may benefit patients, but could not reduce postoperative intestinal obstruction. At the same time, Seprafilm did increase
abdominal abscesses and anastomotic leaks. |
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