Efficacy and safety of Seprafilm for preventing intestinal obstruction after gastrointestinal neoplasms surgery: a systematic review and meta-analysis.

Abstract

OBJECTIVE:

It was controversial that hyaluronate-carboxy-methylcellulose-based membrane (Seprafilm) could prevent intestinal obstruction after gastrointestinal neoplasms operation. This study aimed to evaluate the efficacy and safety of Seprafilm in preventing postoperative intestinal obstruction of gastrointestinal neoplasms patients.

METHODS:

A systematic research of multiple databases was performed to identify relevant studies, and the studies satisfying the inclusion criteria were included. Risk ratio (RR), weighted mean difference (WMD), and 95% confidence intervals were calculated using RevMan 5.3.

RESULTS:

2937 patients from 10 studies who were enrolled in this meta-analysis were divided into the Seprafilm group (n = 1334) and the control group (n = 1603). The Seprafilm group had lower incidence of intestinal obstruction (RR, 0.52; 95% CI, 0.38-0.70; p < .0001), reoperation rates due to intestinal obstruction (RR, 0.48; 95% CI, 0.28 - 0.80; p = .005), incidence of overall complications (RR, 0.77; 95% CI, 0.61-0.97; p = .03) and higher serum creatinine on postoperative day 5 (WMD, 0.15; 95% CI, 0.05-0.25; p = .003). There were no differences regarding time to intestinal obstruction after operation, aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen, white blood cell count results on day 5 and 7, serum creatinine on day 7, hospital stay, and incidence of intra-abdominal infection, wound infection, anastomotic leakage between the 2 groups.

CONCLUSIONS:

This meta-analysis provided valuable evidence-based support for the efficacy and safety of Seprafilm in preventing postoperative intestinal obstruction of gastrointestinal neoplasms patients. However, more multicenter randomized controlled trials from different countries are needed.

• Authors: Jiefeng Zhao, Chao Huang, Jisheng Zhu, Jinfeng Zhu, Rongfa Yuan, Zhengming Zhu
• Journal: Acta chirurgica Belgica (Acta Chir Belg) Vol. 121 Issue 1 Pg. 1-15 (Feb 2021) ISSN: 0001-5458 [Print] England
• PMID: 33459577 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Chemical References

• Seprafilm
• Hyaluronic Acid

Topics

• Digestive System Surgical Procedures
• Gastrointestinal Neoplasms (surgery)
• Humans
• Hyaluronic Acid (therapeutic use)
• Intestinal Obstruction (etiology, prevention & control)
• Multicenter Studies as Topic
• Postoperative Complications (epidemiology, prevention & control)