Association between the antiadhesion membrane and small bowel obstruction after open gastrectomy: A supplemental analysis of the randomized controlled JCOG1001 trial.

Postoperative small bowel obstruction (SBO) is one of the major complications that is mainly caused by postoperative adhesion. Recently, the antiadhesion membrane has become popular for postoperative SBO prevention. However, its efficacy is yet to be confirmed in the gastric cancer surgery field. Here, we conducted the supplemental analysis of the randomized controlled trial JCOG1001 to investigate the efficacy of the antiadhesion membrane on SBO prevention in patients with open gastrectomy for gastric cancer. Of the 1204 patients enrolled in JCOG1001, 1200 patients were included. The development of SBO of Grade ≥ IIIa according to the Clavien-Dindo classification was recorded. Univariable and multivariable analyses were performed using the Fine and Gray model to determine the risk factors for SBO. Fifty-one patients developed SBO (median follow-up duration: 5.6 years). Total gastrectomy, combined resection, and blood loss significantly increased the risk for SBO development in the univariable analysis. Large amount of blood loss was independently associated with SBO development in the multivariable analysis (hazard ratio [HR], 3.089; 95% confidence interval [CI], 1.562-6.109, Antiadhesion membrane did not decrease SBO occurrence rate after open gastrectomy. Therefore, the use of antiadhesion membrane would not be effective for preventing SBO in gastric cancer surgery.

Informations de copyright

© 2023 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.

Déclaration de conflit d'intérêts

Yuichiro Doki and Yukinori Kurokawa are editorial board members of Annals of Gastroenterological Surgery. Junki Mizusawa has received personal fees from Taiho Pharmaceutical outside the submitted work, and his spouse is employed by Pfizer. Takeshi Sano has received personal fees from Taiho, Chugai, Ono, Lilly, and Daiichi‐Sankyo, outside the submitted work. Mitsuru Sasako has received personal fees from Chugai, Taiho, and Daiichi‐Sankyo outside the submitted work. For the remaining authors (Tetsuro Toriumi, Masanori Terashima, Kohei Uemura, Yukinori Kurokawa, Shuji Takiguchi, Yuichiro Doki, Jun Hihara, Hiroshi Imamura, Akinori Takagane, Seiji Ito, and Takaki Yoshikawa), none were declared.