The Primary Result of Prospective Randomized Multicenter Trial of New Spray-Type Bio-absorbable Adhesion Barrier System (TCD-11091) Against Postoperative Adhesion Formation

Takeshi Suto, Masahiko Watanabe, Takeshi Endo, Koji Komori, Masayuki Ohue, Yukihide Kanemitsu, Masaaki Itou, Yasumasa Takii, Toshimasa Yatsuoka, Manabu Shiozawa, Tetsushi Kinugasa, Hideki Ueno, Tadatoshi Takayama, Tadahiko Masaki, Hiroyuki Masuko, Hisanaga Horie, Masafumi Inomata, Takeshi Suto, Masahiko Watanabe, Takeshi Endo, Koji Komori, Masayuki Ohue, Yukihide Kanemitsu, Masaaki Itou, Yasumasa Takii, Toshimasa Yatsuoka, Manabu Shiozawa, Tetsushi Kinugasa, Hideki Ueno, Tadatoshi Takayama, Tadahiko Masaki, Hiroyuki Masuko, Hisanaga Horie, Masafumi Inomata

Abstract

Background: Postoperative adhesions are the major cause of postoperative complications including intestinal obstruction, infertility, and chronic pelvic pain. In order to reduce postoperative adhesions, Terumo Corporation (Tokyo, Japan) has developed an adhesion barrier system (TCD-11091) which is easy to use at the treatment site in various surgical procedures including laparoscopic surgeries. We conducted a prospective randomized single-blind study in patients who underwent laparotomy with ileostomy.

Methods and results: One hundred twenty-six patients were randomly assigned to TCD-11091 group (n = 62) or non-treatment group (n = 62). Patient backgrounds were similar between the groups. At the time of ileostomy closure (the second-look surgery), the observation was performed on 55 in the TCD-11091 group and 43 in the control group. The incidence of adhesions observed at the second-look surgery was significantly lower in the TCD-11091 group (52.7 versus 90.7%; p < 0.001). For the secondary endpoints, the incidence of wide extent adhesions (grade 2 or higher) was significantly reduced (38.2 versus 79.1%; p < 0.001). Regarding the severity of adhesions, the incidence of grade 2 or higher adhesions was also significantly lower in the TCD-11091 group (47.3 versus 88.4%; p < 0.001). No differences in the incidence of adverse events were found between the TCD-11091 group and the non-treatment group (85.2 versus 75.4%; p = 0.225).

Conclusions: Use of TCD-11091 was safe and associated with significantly lower incidence of adhesion and severity of adhesions compared with non-treatment procedure.

Keywords: Adhesions; Adspray; Randomized-control trial; Rectal cancer; Sprayer.

Conflict of interest statement

This study was approved by the institutional review board (IRB) at each participated institutes. All patients signed the informed consent form.

Figures

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Patient flow chart
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Incidence of adhesions
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Extent of adhesions
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Severity of adhesions

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