Objectives: The use of laparoscopic surgical techniques for the resection of intraperitoneal malignancies has been rapidly increasing in recent years; concomitantly, tumor recurrences at trocar sites have also been reported. These reports bring into quest

Objective: Postoperative intra-abdominal adhesions are a major source of postsurgical morbidity. Pelvic irradiation increases the likelihood of adhesion development. The purpose of this study was to evaluate the effects of hyaluronic acid–carboxymethylcellulose film, which was designed as a barrier to prevent adhesions, on the healing of ileal anastomoses performed on irradiated rat bowel. Study Design: Sixty-eight female Sprague-Dawley rats underwent whole pelvic irradiation with a single fraction of 1700 cGy. Twenty weeks later the rats underwent exploratory laparotomy with segmental ileal resection and reanastomosis. Eighteen of the anastomoses were wrapped in hyaluronic acid–carboxymethylcellulose film. Fifty anastomoses were not treated with any adhesion-inhibiting barrier. On the fifth postoperative day the animals underwent another laparotomy for evaluation of the anastomotic sites. Results: At the second laparotomy 93% of the rats treated with hyaluronic acid–carboxymethylcellulose film were found to have perianastomotic abscesses. In the non–hyaluronic acid–carboxymethylcellulose film group the perianastomotic abscess rate was 24% (P< .0001). Conclusion: Among previously irradiated rats undergoing small-bowel resection and anastomosis, hyaluronic acid–carboxymethylcellulose film was associated with a markedly increased rate of abscess formation at the operative site. (Am J Obstet Gynecol 1999;181:1335-8.)