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Cited by 7Intestinal and Peritoneal AdhesionsHernia repair and managementEnhanced Recovery After Surgery

Laparoscopic application of sodium hyaluronate–carboxymethylcellulose barrier in abdominopelvic surgery: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Systematic Review Protocols–compliant systematic review and meta-analysis

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Siebert, Terri, Moersdorf, Gerhard, Colberg, Torben·2024·Surgery
DOI 10.1016/j.surg.2024.01.014
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Abstract

Background We aimed to evaluate the incidence of postoperative adhesion formation and adhesion-related consequences (eg, bowel obstruction) after placement of a sodium hyaluronate–carboxymethylcellulose adhesion barrier after laparoscopic abdominopelvic surgery. Methods In this systematic review and meta-analysis, we searched the Medical Literature Analysis and Retrieval System Online and Embase via Ovid, Cochrane Central Register of Controlled Trials, ScienceDirect, BIOSIS Previews, Cumulative Index to Nursing and Allied Health Literature, and Clinical Trial Registries. A manual search (eg, Google Scholar and professional association websites) was also conducted to supplement the electronic database results. Two reviewers independently identified relevant studies based on inclusion and exclusion criteria and extracted data. Results A total of 28 studies were included in the systematic qualitative review. Three of the 28 studies included had comparable outcome measures, interventions, and control groups, allowing the pooling of study data. A total of 938 patients (490 patients in the sodium hyaluronate–carboxymethylcellulose barrier group and 448 in the no adhesion barrier group) from these 3 studies were included in the meta-analyses, which found the incidence of bowel obstruction was significantly lower (65% risk reduction) in the sodium hyaluronate–carboxymethylcellulose barrier group compared with the control group (relative risk = 0.35; 95% confidence interval, 0.19–0.63; P = .005) with extremely low heterogeneity between studies ( I 2 = 0; P = .41). The placement of sodium hyaluronate–carboxymethylcellulose barrier laparoscopically did not create new safety signals nor did it increase the incidence of adverse events. Conclusion Our meta-analysis found that laparoscopic application of a sodium hyaluronate–carboxymethylcellulose barrier in abdominopelvic surgery reduces the risk of bowel obstruction where applied during the early postoperative phase.

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  • Established HA-based products Hyalobarrier (gel) and Seprafilm (sheet) have demonstrated clinical efficacy in reducing adhesion formation, particularly in gynecologic and colorectal surgeries, with acceptable safety profiles.

    “Established products like Hyalobarrier (gel) and Seprafilm (sheet) have demonstrated clinical efficacy in reducing adhesion formation—particularly in gynecologic and colorectal surgeries—with acceptable safety profiles [124].”

    From Biomaterials in Postoperative Adhesion Barriers and Uterine Tissue Engineering (2025) · cites this paper as [124]

    The Discussion (page not available in our copy) reports that laparoscopically placed Seprafilm reduced postoperative bowel obstruction in colorectal surgery, using obstruction as a surrogate for adhesion formation; the Study limitations section reports no new safety signals or increase in adverse events. The paper does not address Hyalobarrier gel, and its colorectal result does not establish reduced adhesion formation for both products across gynecologic and colorectal surgery. (LLM, conf=0.88)

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Cited by

Sorted by citations

Authors
Siebert, T., Moersdorf, G., & Colberg, T.
Affiliations
Baxter (United States) (US)
Corresponding author
Siebert, Terri
ORCID
Venue
Surgery
Publisher
Elsevier BV
Published
2024-05
Volume
175
Issue
5
Pages
1358-1367
ISSN
0039-6060 (ISSN-L)
DOI
10.1016/j.surg.2024.01.014
OpenAlex
W4392356175
Cited by
7
References
3
Citations by year
2026: 4 · 2025: 3
FWCI
0.71
Type
journal article
Language
en
Open access
Licence
Locations
  • Surgery (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
  • Baxter Healthcare Corporation
  • Baxter International Inc
Topics
  • Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
  • Health Sciences › Medicine › Surgery › Hernia repair and management
  • Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
Keywords
anti-adhesion barrier, postoperative adhesions, intestinal obstruction, adhesion prevention, postoperative complications
MeSH terms
Abdomen, Systematic Reviews as Topic, Tissue Adhesions, Carboxymethylcellulose Sodium, Humans, Hyaluronic Acid, Intestinal Obstruction, Pelvis, Laparoscopy, Postoperative Complications

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