The Effectiveness of Anti-Adhesion Barriers on Prevention of Postoperative Adhesive Bowel Obstruction: Disease-Free...

Anti-adhesion barriers are effective in reducing adhesion formation, but their impact on preventing adhesive bowel obstruction remains unclear. This study aimed to evaluate the effectiveness of anti-adhesion barriers in preventing adhesive bowel obstruction using a nationwide medical database in Japan.

Surgical cases for abdominal gastroenterological cancers were categorized into six categories based on procedure type (Open or Laparoscopic) and target organ (Stomach, Colorectum, and Hepatobiliary-pancreas). Patients were classified into an anti-adhesion barriers group (treatment) or a non-anti-adhesion barriers group (comparison). Propensity score matching was performed to balance baseline characteristics. Survival analysis with hospitalizations due to adhesive bowel obstruction as the outcome was conducted, and hazard ratios (HR) were calculated using univariate Cox regression analysis.

A total of 163 194 cases were analyzed. In the Open Colorectum and Laparoscopic Colorectum categories, the cumulative incidence curve for the treatment group was lower than that of the comparison group (Log-rank test; Open Colorectum: p < 0.01, Laparoscopic Colorectum: p = 0.01). The HR was significantly lower in both categories (Open Colorectum: 0.87 [95% CI: 0.80-0.95], Laparoscopic Colorectum: 0.84 [95% CI: 0.73-0.96]). In other categories, no significant differences were found between the two groups. [Correction added on 2 February 2026, after first online publication: The p values of Open Colorectum and Laparoscopic Colorectum have been corrected.].

This study suggests that anti-adhesion barriers use could effectively reduce the risk of adhesive bowel obstruction in Open Colorectum and Laparoscopic Colorectum surgeries, but not in Open Stomach, Open Hepatobiliary-pancreas, or Laparoscopic Stomach surgeries. Further research is needed to confirm these findings and explore broader applications.