Role of Fibrin Glue in the Prevention of Cervical Leakage and Strictures After Esophageal Reconstruction of Caustic Injury

Saldaña-Cortés, Julián Alberto; Larios-Arceo, Francisco; Prieto-Díaz-Chávez, Emilio; Buen, Eliseo Portilla-de; González-Mercado, Salvador; Álvarez-Villaseñor, Andrea Socorro; Prieto-Aldape, Manuel Rodrigo; González-Ojeda, Alejandro

doi:10.1007/s00268-009-9949-x

Cited by 25 publications

(18 citation statements)

References 43 publications

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“…MBP was routinely performed before all colonic procedures in our institution, similar to other centers 9,10 . However, since July 2008, we have not been performing MBP before esophagocoloplasty procedures.…”

Section: Discussionmentioning

confidence: 98%

“…This complication, however, is benign, and the leak heals spontaneously, without the need for any additional surgical intervention. In an attempt to prevent this complication, some new techniques have been recently described, such as the use of fibrin glue around the cervical esophagocolic anastomosis 10 . We believe that the keys to better results are improvements in the preoperative nutritional status of the patient and the details of operative technique, like improvements in colon graft irrigation and a delicate cervical esophagocolic anastomosis.…”

Section: Discussionmentioning

confidence: 99%

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Mechanical bowel preparation for esophagocoloplasty in children: is it really necessary?

Leal

Tannuri

2012

Diseases of the Esophagus

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Esophagocoloplasty is a commonly performed procedure for esophageal replacement in children. Traditionally, mechanical bowel preparation (MBP) is performed before this operation. However, this practice has been questioned, initially in adults and now in children. The aim of this study was to evaluate the influence of MBP on esophagocoloplasty in a series of children. Data collected from 164 patients who underwent esophagocoloplasty in the Pediatric Surgery Division, University of São Paulo Medical School, from February 1978 to July 2011 were reviewed for postoperative complications. In 134 patients, at least one kind of MBP was performed before the surgery (PREP group). MBP was omitted in 30 patients (NO-PREP group). There was no statistical difference between the groups in the rates of evisceration, colocolic, or cologastric anastomotic dehiscence and death. However, in the NO-PREP group, the incidence of cervical leakage (6.6%) was significantly decreased in comparison with the classical PREP group (25.3%) (P= 0.03). The results of this study suggest that the omission of MBP has a positive impact on the incidence of postoperative complications in esophagocoloplasty.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Mechanical bowel preparation for esophagocoloplasty in children: is it really necessary?

Leal

Tannuri

2012

Diseases of the Esophagus

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“…Equally, fibrin glue did not show any improvements in two studies involving laparoscopic gastric bypasses [31, 32]. Yet, leakages after (colo) esophageal anastomoses in children were significantly reduced by fibrin glue [33, 34]. …”

Section: Discussionmentioning

confidence: 99%

Collagen fleeces do not improve colonic anastomotic strength but increase bowel obstructions in an experimental rat model

Schreinemacher

Bloemen

Heijden

et al. 2011

Int J Colorectal Dis

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PurposeTo investigate whether a collagen fleece kept in place by fibrin glue might seal off a colorectal anastomosis, provide reinforcement, and subsequently improve anastomotic healing.MethodsWistar rats underwent a 1-cm left-sided colonic resection followed by a 4-suture end-to-end anastomosis. They were then randomly assigned to one of three treatment groups: no additional intervention (control, n = 20), the anastomosis covered with fibrin glue (fibrin glue, n = 20), the anastomosis covered with a collagen fleece, kept in place with fibrin glue (collagen fleece, n = 21). At either 3 or 7 days follow-up, anastomotic bursting pressure was measured and tissue was obtained for histology and collagen content assessment after which animals were sacrificed.ResultsThree rats in the control (15%), three in the fibrin glue (15%), and one in the collagen group (4.8%) died due to anastomotic complications (P = 0.497). Anastomotic bursting pressures were not significantly different between groups at 3 and 7 days follow-up (P = 0.659 and P = 0.427, respectively). However, bowel obstructions occurred significantly more often in the collagen group compared to the control group (14/21 vs. 3/20, P = 0.003). Collagen contents were not different between groups, but histology showed a more severe inflammation in the collagen group compared to the other groups at both 3 and 7 days follow-up.ConclusionsA collagen fleece kept in place by fibrin glue does not improve healing of colonic anastomoses in rats. Moreover, this technique induces significantly more bowel obstructions in rats, warranting further study before being translated to a clinical setting.

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“…intraoperative Fibrinbehandlung [16][17][18][19][20][21]). Weitere Studien berichten über positive Erfahrungen mit der postoperativen prophylaktischen Einlage einer Dekompressionssonde [22] nach tiefer anteriorer Rektumresektion oder der routinemäßigen intraoperativen endoskopischen Inspektion der frischen Anastomose [23].…”

Section: Over-the-scope-clip-systemunclassified

Endoskopische Möglichkeiten der Behandlung von Nahtinsuffizienzen im Rektum

Steinkamp¹,

Gress²

2012

Visc Med

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Hintergrund: Anastomoseninsuffizienzen stellen eine gefürchtete Komplikation der kolorektalen Chirurgie dar. Endoskopische Techniken haben sich in der Therapie der Leckagen zunehmend etabliert. In dieser Übersicht möchten wir einen Überblick der wichtigsten endoskopischen Verfahren geben. Methode: Systematische Recherche der vorhandenen Literatur. Ergebnisse: Die bedeutendsten endoskopischen Verfahren zur Behandlung der kolorektalen Anastomoseninsuffizienzen stellen die Fibrininjektion, die Vakuumschwammtherapie (Endo-Sponge), spezielle Clip-Systeme (OTSC) sowie die Stentimplantation dar. Der breiten klinischen Anwendung dieser Verfahren steht jedoch eine unzureichende Studienlage gegenüber. Schlussfolgerung: Die Einschätzung der Wertigkeit der einzelnen endoskopischen Verfahren untereinander und in speziellen therapeutischen Situationen hängt im Wesentlichen von der Erfahrung der Untersucher ab. Es bedarf der Durchführung randomisierter, prospektiver Studien, um diese Erfahrungen zu objektivieren.

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Role of Fibrin Glue in the Prevention of Cervical Leakage and Strictures After Esophageal Reconstruction of Caustic Injury

Abstract: Fibrin glue, when used as a sealant for cervical coloesophageal anastomosis, can reduce the risk of leakage and stricture.

Cited by 25 publications

References 43 publications

Mechanical bowel preparation for esophagocoloplasty in children: is it really necessary?

Mechanical bowel preparation for esophagocoloplasty in children: is it really necessary?

Collagen fleeces do not improve colonic anastomotic strength but increase bowel obstructions in an experimental rat model

Endoskopische Möglichkeiten der Behandlung von Nahtinsuffizienzen im Rektum

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