Adhesion barriers for abdominal surgery and oncology

摘要

We read with great interest Richard ten Broek and colleagues' meta-analysis1 about the use of four different anti-adhesion barriers. Reoperation for adhesive small bowel obstruction was the primary outcome. The authors suggest their results should inform the development of guidelines for the use of barriers to prevent long-term adhesion-related complications for abdominal surgery in general. However, these results are not applicable to surgical oncology. In stage IV colorectal cancer, which is the most frequent cancer affecting the abdomen, advances in chemotherapy during the past decade have enabled us to increase the number of patients treated with repeated abdominal surgery and therefore, exposed to adhesiolysis-related morbidity. As ten Broek and colleagues noted, adhesiolysis is associated with an increase in bowel injury and septic complications.2 Moreover, adhesiolysis time predicts enterotomy.