J Korean Surg Soc.  2013 Mar;84(3):160-167.

Current status of the use of antiadhesive agents for gastric cancer surgery: a questionnaire survey in South Korea

• Park JH
• Jeong SH
• Lee YJ
• Choi SK
• Hong SC
• Jung EJ
• Jeong CY
• Ju YT
• Ha WS

Abstract

PURPOSE
The aim of this study was to investigate the current status of the use of antiadhesive agents (AAdAs) via a questionnaire and to discuss the availability of AAdAs.
METHODS
The survey was sent to a list of members that was approved by the Korean Gastric Association. The survey included questions on AAdA use by surgeons, the type of AAdAs used, and the reasons for not using AAdAs. Surgeons were also asked to describe complications related to AAdAs, and the reliability of its use.
RESULTS
The response rate was 21%. The rates of frequent use stratified by procedure were 26.9% (14/52) for open gastrectomy, 5.9% (3/51) for laparoscopic gastrectomy, and 31.5% (17/54) for surgery for postoperative bowel obstruction (P < 0.01). After including data from the occasional use group, the corresponding values were 51.9% (27/52), 19.6% (10/51), and 70.4% (38/54), respectively (P < 0.01). Sefrafilm and Guardix were most commonly used for open procedures. Guardix and Interceed were most commonly used for laparoscopic surgery. The primary reasons for nonuse of AAdAs were ineffectiveness and high cost. Ten percent (4/40) of surgeons observed complications associated with AAdAs. A minority (17.3%, 9/52) had positive attitudes toward AAdAs. The majority of respondents expressed neutral (73.1%, 38/52) or negative (9.6%, 5/52) attitudes toward AAdAs.
CONCLUSION
The low use rates of AAdAs in gastric cancer surgery may be attributable to perceptions that AAdAs are ineffective, unreliable, and costly. We anticipate the emergence of promising antiadhesive strategies that reach far beyond the limitations of current products.

Keyword

Peritoneal adhesions; Questionnaires; Adhesion barriers; Postoperative complication; Stomach neoplasms

MeSH Terms

Cellulose, Oxidized
Gastrectomy
Laparoscopy
Morinda
Postoperative Complications
Surveys and Questionnaires
Republic of Korea
Stomach Neoplasms
Surveys and Questionnaires
Cellulose, Oxidized

Figure

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  Fig. 1 Whether to use of antiadhesive agents. OG, open gastrectomy; LG, laparoscopic gastrectomy; POO, surgery for postoperative bowel obstruction.

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  Fig. 2 Type of applying antiadhesive agents. OG, open gastrectomy; LG, laparoscopic gastrectomy; POO, surgery for postoperative bowel obstruction.

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