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

Int J Colorectal Dis. 2019 Mar;34(3):513-518. doi: 10.1007/s00384-018-03229-3. Epub 2019 Jan 7.

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: Adhesion; Colorectal cancer; Laparoscopy; Stoma.

MeSH terms

  • Abdominal Cavity / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Colorectal Neoplasms / surgery*
  • Colorectal Surgery*
  • Female
  • Humans
  • Laparoscopy*
  • Logistic Models
  • Male
  • Middle Aged
  • Surgical Stomas / pathology*
  • Tissue Adhesions / surgery*
  • Tissue Adhesives / pharmacology*
  • Treatment Outcome

Substances

  • Tissue Adhesives