1
|
Kim SJ, Shin JM, Lee EJ, Park IH, Lee HM, Kim KS. Efficacy of hyaluronic acid and hydroxyethyl starch in preventing adhesion following endoscopic sinus surgery. Eur Arch Otorhinolaryngol 2017; 274:3643-3649. [PMID: 28707086 DOI: 10.1007/s00405-017-4669-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 07/07/2017] [Indexed: 11/30/2022]
Abstract
Adhesion is a major complication of endoscopic sinus surgery that may lead to recurrence of chronic rhinosinusitis, necessitating revision surgery. The purpose of this study was to evaluate the effect of hyaluronic acid and hydroxyethyl starch (HA-HES) relative to hyaluronic acid and carboxymethylcellulose (HA-CMC) with regard to anti-adhesion effect. In this multi-center, prospective, single-blind, randomized controlled study, 77 consecutive patients who underwent bilateral endoscopic sinus surgery were enrolled between March 2014 and March 2015. HA-HES and HA-CMC were applied to randomly assigned ethmoidectomized cavities after the removal of middle meatal packing. At the 1st, 2nd and 4th weeks after surgery, the presence and grades of adhesion, edema, and infection were, respectively, examined via endoscopy by a blinded assessor. The incidence and grades of adhesion at the 2-week follow-up were significantly less in the HA-CMC group than in the HA-HES group (p < 0.05). However, with the exception of week 2, there were no significant differences in the incidence or grades of adhesion, edema, and infection between the two groups. When the primary endpoint-the presence of adhesion at the 4-week follow-up-was compared between two groups, the incidence of adhesion in HA-HES group at the 4-week follow-up was 32% and in HA-CMC was 41.3%, indicating that HA-HES was not inferior to HA-CMC in terms of anti-adhesive effect. No severe adverse reactions were noted during the study period. In conclusion, HA-HES is a safe substitutional anti-adhesion agent that has equivalent effect as HA-CMC after endoscopic sinus surgery.
Collapse
Affiliation(s)
- Su-Jong Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul, 152-703, South Korea
| | - Jae-Min Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul, 152-703, South Korea
| | - Eun Jung Lee
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, South Korea
| | - Il-Ho Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul, 152-703, South Korea
| | - Heung-Man Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul, 152-703, South Korea. .,Division of Brain Korea 21 Program for Biomedical Science, Korea University College of Medicine, Seoul, South Korea. .,In vitro Diagnostic Medical Devices Support Center, Korea University Guro Hospital, Seoul, South Korea.
| | - Kyung-Su Kim
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, South Korea.
| |
Collapse
|
2
|
Picaud L, Thibault B, Mery E, Ouali M, Martinez A, Delord JP, Couderc B, Ferron G. Evaluation of the effects of hyaluronic acid-carboxymethyl cellulose barrier on ovarian tumor progression. J Ovarian Res 2014; 7:40. [PMID: 24739440 PMCID: PMC3996858 DOI: 10.1186/1757-2215-7-40] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 03/25/2014] [Indexed: 12/04/2022] Open
Abstract
Background Hyaluronic acid is a prognostic factor in ovarian cancers. It is also a component of Hyaluronic Acid-Carboxymethyl Cellulose (HA-CMC) barrier, an anti-adhesion membrane widely used during abdominal surgeries in particular for ovarian carcinosis. 70% of patients who undergo ovarian surgery will relapse due to the persistence of cancer cells. This study’s objective was to determine the oncological risk from use of this material, in the presence of residual disease, despite the benefit gained by it decreasing post-surgical adhesions in order to provide an unambiguous assessment of its appropriateness for use in ovarian surgical management. Methods We assessed the effects of HA-CMC barrier on the in vitro proliferation of human ovarian tumor cell lines (OVCAR-3, IGROV-1 and SKOV-3). We next evaluated, in vivo in nude mice, the capacity of this biomaterial to regulate the tumor progression of subcutaneous and intraperitoneal models of ovarian tumor xenografts. Results We showed that HA-CMC barrier does not increase in vitro proliferation of ovarian cancer cell lines compared to control. In vivo, HA-CMC barrier presence with subcutaneous xenografts induced neither an increase in tumor volume nor cell proliferation (Ki67 and mitotic index). With the exception of an increased murine carcinosis score in peritoneum, the presence of HA-CMC barrier with intraperitoneal xenografts modified neither macro nor microscopic tumor growth. Finally, protein analysis of survival (Akt), proliferation (ERK) and adhesion (FAK) pathways highlighted no activation on the xenografts imputable to HA-CMC barrier. Conclusions For the most part, our results support the lack of tumor progression activation due to HA-CMC barrier. We conclude that the benefits gained from using HA-CMC barrier membrane during ovarian cancer surgeries seem to outweigh the potential oncological risks.
Collapse
Affiliation(s)
- Laetitia Picaud
- EA4553, Institut Claudius Regaud, 20-24 rue du pont St Pierre, 31052 Toulouse, France ; Surgery Department, Institut Claudius Regaud, 20-24 rue du pont St Pierre, 31052 Toulouse, France
| | - Benoît Thibault
- EA4553, Institut Claudius Regaud, 20-24 rue du pont St Pierre, 31052 Toulouse, France
| | - Eliane Mery
- EA4553, Institut Claudius Regaud, 20-24 rue du pont St Pierre, 31052 Toulouse, France
| | - Monia Ouali
- Biostatistic Unit, Institut Claudius Regaud, 20-24 rue du pont St Pierre, 31052 Toulouse, France
| | - Alejandra Martinez
- Surgery Department, Institut Claudius Regaud, 20-24 rue du pont St Pierre, 31052 Toulouse, France
| | - Jean-Pierre Delord
- EA4553, Institut Claudius Regaud, 20-24 rue du pont St Pierre, 31052 Toulouse, France ; Université de Toulouse, Université Paul Sabatier, 118, Route de Narbonne, F-31062 Toulouse, France
| | - Bettina Couderc
- EA4553, Institut Claudius Regaud, 20-24 rue du pont St Pierre, 31052 Toulouse, France ; Université de Toulouse, Université Paul Sabatier, 118, Route de Narbonne, F-31062 Toulouse, France
| | - Gwenael Ferron
- EA4553, Institut Claudius Regaud, 20-24 rue du pont St Pierre, 31052 Toulouse, France ; Surgery Department, Institut Claudius Regaud, 20-24 rue du pont St Pierre, 31052 Toulouse, France
| |
Collapse
|
3
|
Huang JC, Yeh CC, Hsieh CH. Laparoscopic Management for Seprafilm-Induced Sterile Peritonitis With Paralytic Ileus: Report of 2 Cases. J Minim Invasive Gynecol 2012; 19:663-6. [DOI: 10.1016/j.jmig.2012.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 04/19/2012] [Accepted: 04/28/2012] [Indexed: 12/19/2022]
|