Transient Protection of Incomplete Colonic Anastomoses with Fibrin Sealant: An Experimental Study in the Rat

Ham, Arie C. van der; Kort, Will J.; Weijma, Ineke M.; Jeekel, Hans

doi:10.1006/jsre.1993.1137

Cited by 57 publications

(53 citation statements)

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“…Of the 8 studies with no effect on healing, 6 studies revealed a positive effect on bursting pressure or anastomotic strength [70,75,76,77,78,80]. Similar findings were seen in the group of studies reporting a negative effect on healing, where 1 study found a positive effect on bursting pressure and anastomotic strength [63], 6 studies found no effect on these mechanical end points [62,64,65,66,67,68] and only 1 study found a negative effect on bursting pressure [69]. On the contrary, all of the 7 studies that reported a positive effect on healing also showed a positive effect on the mechanical end points [55,56,57,58,59,60,61].…”

Section: Discussionsupporting

confidence: 69%

“…In 7 of the 28 studies, a positive effect of FG on healing was found [55,56,57,58,59,60,61], while 8 studies reported a negative effect [62,63,64,65,66,67,68,69] and 11 studies found no effect [54,70,71,72,73,74,75,76,77,78,79]. Furthermore, 2 studies reported unclear results [80,81] (table 2).…”

Section: Resultsmentioning

confidence: 99%

“…In 1 study on colonic anastomoses in rats, compromised healing after FG sealing was demonstrated, and these findings were hypothesized to be due to an inflammatory reaction caused by the sealing [64]. In 2 other studies, it was found that FG sealing inhibited healing of normal colon anastomoses in rats [65,69]. The hypothesis there was an increased inflammatory activity, which caused an increased production of collagenase and thereby reduced collagen concentration.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, many of these attempts have failed to show convincing results [18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48]. Numerous studies have reported on the sealing of gastrointestinal anastomoses with fibrin glue (FG), also called fibrin sealant.…”

Section: Introductionmentioning

confidence: 99%

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Fibrin Glue Does Not Improve Healing of Gastrointestinal Anastomoses: A Systematic Review

et al. 2014

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Background/Aim: Anastomotic leakage remains a frequent and serious complication in gastrointestinal surgery. In order to reduce its incidence, several clinical and experimental studies on anastomotic sealing have been performed. In a number of these studies, the sealing material has been fibrin glue (FG), and the results in individual studies have been varying. The positive effect of anastomotic sealing with FG might be due to the mechanical/physical properties, the increased healing of the anastomoses or both. The aim of this systematic review was to evaluate the existing evidence on the healing effects of FG on gastrointestinal anastomoses. Methods: PubMed, EMBASE and the Cochrane databases were searched for studies evaluating the healing process of gastrointestinal anastomoses after any kind of FG application. The search period was from 1953 to December 2013. Results: Twenty-eight studies were included in the qualitative synthesis. These studies were all experimental studies, since no human studies used histological or biochemical evaluation of healing. In 7 of the 28 studies, a positive effect of FG on healing was found, while 8 studies reported a negative effect and 11 studies found no effect. Furthermore, 2 studies reported unclear results. The difference in the study outcome was independent of the study design and the type of FG used. Conclusion: In the available studies, FG did not consistently have a positive influence on the healing of gastrointestinal anastomoses. It is consequently plausible that the positive effect of FG sealing of gastrointestinal anastomoses, if there is any, may be due to a mechanical sealing effect rather than due to improved healing per se.

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Section: Discussionsupporting

confidence: 69%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fibrin Glue Does Not Improve Healing of Gastrointestinal Anastomoses: A Systematic Review

et al. 2014

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“…However, some studies have attempted to develop a clinical colon anastomotic leakage model in the rat. Van der Ham et al [23] examined signs of clinical leakage in the rat by comparing insufficient colonic anastomoses with 4 interrupted sutures at 90° with normal anastomoses (12 interrupted sutures). The level of the anastomosis was at the left colon 3 cm proximal to the peritoneal reflection.…”

Section: Animalsmentioning

confidence: 99%

Choosing the Best Animal Species to Mimic Clinical Colon Anastomotic Leakage in Humans: A Qualitative Systematic Review

Pommergaard

Rosenberg²,

Schumacher-Petersen³

et al. 2011

Eur Surg Res

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Background/Aims: Animal models are valuable for studying pathogenic factors and preventive measures for colon anastomotic leakage. The suitability of the species as models varies greatly; however, no consensus exists on which species to use. The aim of this review was to evaluate different experimental animals for the study of clinical colon anastomotic leakage. Methods: PubMed and REX database were searched up to October 2010 to identify studies evaluating clinical colon anastomotic leakage in animal models and textbooks on experimental animals, respectively. Results: Functional models of clinical colon anastomotic leakage have been developed in the mouse, pig, rat, dog and rabbit. However, extreme interventions are needed in order to produce clinical leakage in the rat. Conclusion: Despite the wide use of the rat in this field of research, it seems that its resistance to intra-abdominal infection makes clinical leakage difficult to produce thus rendering the rat unsuited as a model. On the basis of the available literature, we recommend using mice as models mimicking clinical colon anastomotic leakage. Pigs may be an alternative; however, the existing models in this animal are less validated and clinically relevant.

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A light-activated amnion wrap strengthens colonic anastomosis and reduces peri-anastomotic adhesions

et al. 2016

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Transient Protection of Incomplete Colonic Anastomoses with Fibrin Sealant: An Experimental Study in the Rat

Cited by 57 publications

References 0 publications

Fibrin Glue Does Not Improve Healing of Gastrointestinal Anastomoses: A Systematic Review

Fibrin Glue Does Not Improve Healing of Gastrointestinal Anastomoses: A Systematic Review

Choosing the Best Animal Species to Mimic Clinical Colon Anastomotic Leakage in Humans: A Qualitative Systematic Review

A light-activated amnion wrap strengthens colonic anastomosis and reduces peri-anastomotic adhesions

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