Colonic Anastomoses Protected with Fibrin Sealant (Tissucol/Tisseel)

Giardino, Roberto; Brulatti, M.; Franchini, A

doi:10.1007/978-3-642-95513-6_19

Cited by 12 publications

(2 citation statements)

References 3 publications

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“…Results are controversial. Some studies in dogs [130] and humans [117,118,123,131] have demonstrated less postoperative leakage and fewer complications, while other studies suggest that FG sealing increases bursting strength, but may shield the anastomotic site from the host defenses, thus increasing the risk of local infection [124].…”

Section: Gastrointestinal Tract Anastomosesmentioning

confidence: 98%

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Sutureless and Reduced Suture Anastomosis of Hollow Vessels With Fibrin Glue: A Review

Detweiler

Fenton

1999

Journal of Investigative Surgery

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Research in reduced suture fibrin glue (FG) and sutureless FG anastomosis has been lagging behind FG utilization in other surgical fields. A review of the literature for vascular, esophageal, tracheal, gastrointestinal, common bile duct, ureteral, vas deferens, and Fallopian tube FG anastomosis indicates that reduced suture FG and sutureless FG procedures may be performed with less training, reduced operating time, leakage, ischemia, inflammation, and necrosis compared to sutured techniques. Reduced suture FG vascular anastomosis augments early anastomotic strength. Suture number for esophageal, tracheal, and tracheobronchial anastomoses can be reduced with FG. Bursting strength in pig small intestine and rat colon was lower at 4 days postoperatively, but returned to sutured strength at 7 days. Mortality was unaffected, and 18-month follow-up in sutureless FG intestinal anastomosis in pigs showed no stenosis. Preliminary ureteral studies have demonstrated successful sutureless FG and reduced suture FG laparoscopic techniques in pigs. Reduced suture FG and sutureless FG vas deferens anastomosis may reduce sperm granuloma rates, with increased patency and pregnancy rates. Patency and pregnancy rates have been similar for tubal FG, reduced suture FG, autologous fibrin glue (AFG), and sutured anastomosis. Any risk of viral transmission or immune response is eliminated by AFG. While there are few studies in many areas of FG hollow vessel anastomosis, the current literature illustrates many of the advantages of FG over other anastomotic techniques and should provide impetus for continued research in this promising field of surgery.

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Section: Gastrointestinal Tract Anastomosesmentioning

confidence: 98%

“…Fibrin glue has been employed as a protective sealant to avoid leakage in routine and high-risk sutured gastrointestinal anastomoses [23,[117][118][119][120][121][122][123][124][125][126] and in high stapled esophageal and low stapled rectal anastomoses [113,[121][122][123][127][128][129]. Results are controversial.…”

Section: Gastrointestinal Tract Anastomosesmentioning

confidence: 99%

Sutureless and Reduced Suture Anastomosis of Hollow Vessels With Fibrin Glue: A Review

Detweiler

Fenton

1999

Journal of Investigative Surgery

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Fibrin Sealant in High-Risk Colonic Anastomoses

Houston

Rotstein²

1988

Arch Surg

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Effect of fibrin sealant on the healing colonic anastomosis in the rat

Ham

Kort

Weijma

et al. 1991

British Journal of Surgery

112

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Fibrin adhesives have been advocated as a protective seal in colonic anastomosis to prevent leakage. In order to assess the effect of fibrin glue sealing we compared the healing of sutured colonic anastomosis in the rat (group 1) with the addition of human-derived fibrin sealant (group 2). As a control for a possible reaction to foreign protein, in group 3 the sutured anastomosis was sealed with specially prepared rat fibrin adhesive. On days 2, 4 and 7, ten animals in each group were killed. Adhesion formation was scored and the in situ bursting pressure was measured. The collagen concentration and degradation were estimated by measuring hydroxyproline. Adhesion formation was significantly increased in groups 2 and 3 compared with the control group. On days 2 and 7 the bursting pressure was not different between the groups. On day 4 the bursting pressure in groups 2 and 3 was significantly lower than in group 1 (P less than 0.001). These findings correspond with the results of collagen measurements. On day 4 the concentration of hydroxyproline was significantly reduced in groups 2 and 3. Histological examination showed infiltration of neutrophilic granulocytes into the sealant on days 2 and 4; on day 7 the sealant had vanished. From these results it is concluded that fibrin sealing of the colonic anastomosis in the rat does not improve healing, as demonstrated by bursting pressure and hydroxyproline concentration. On the contrary, it seems to have a negative influence.

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Colonic Anastomoses Protected with Fibrin Sealant (Tissucol/Tisseel)

Cited by 12 publications

References 3 publications

Sutureless and Reduced Suture Anastomosis of Hollow Vessels With Fibrin Glue: A Review

Sutureless and Reduced Suture Anastomosis of Hollow Vessels With Fibrin Glue: A Review

Fibrin Sealant in High-Risk Colonic Anastomoses

Effect of fibrin sealant on the healing colonic anastomosis in the rat

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