Aim: To explore the possibility of using hyaluronic acid solution (HAS) for the treatment of intraperitoneal adhesions in children.
Introduction: Adhesive intestinal obstruction (AIO) has been found to be a challenging problem of abdominal surgery with increased occurrence in children worldwide. Intraperitoneal adhesions occur commonly after abdominal surgery and frequently cause intestinal obstruction. Current means of adhesion prevention includes good surgical technique and anti-adhesion barriers. This study is hence directed towards the effect of hyaluronic acid solution (HAS) in reducing the incidence and recurrence of adhesions.
Methods: 84 children were operated on for AIO. 21 children (25%) were operated on for early adhesive intestinal obstruction (EAIO), 63 (75%) – on late adhesive intestinal obstruction (LAIO) and 12 (14.29%) for recurrent AIO. Following surgery, these children were divided into two groups; group I (56 patients) and group II (28 patients). The Hyaluronic Acid Solution; Defensal was used. Follow-up on the children took place from 1 to 4 years.
Results: 13 children (23.21%) in group I were found to have adhesion syndrome in the first year after surgery. This increased to 20 (35.71%) patients over the 4 year period. Children in the II group who had undergone treatment for adhesion syndrome (cured conservatively using HAS) over a 2.5 year postoperative period were not found to have adhesive syndrome at the end of the follow-up period with the exception of 2 (7.14%) patients. When compared to group I patients who had no treatment by the HAS, group II patients showed a higher degree of recovery with minimal recurrence.
Conclusion: Although accompanied by a minimal recurrence rate, HAS shows effectiveness as a treatment for adhesive intestinal obstruction in children. This serves as a step further towards a complete prevention of postoperative adhesion common in children.1–11