Use of absorbable fibrin sealant patch to strengthen the gastrointestinal anastomosis performed on patients with peritoneal carcinomatosis treated with intention to cure by debulking surgery and intraoperative hyperthermic intraperitoneal chemotherapy

Torres-Melero, J; Motos-Micó, José Jacob; Lorenzo-Liñán, Miguel Ángel; Morales-González, Álvaro; Rosado-Cobián, Rafael

doi:10.1016/j.circen.2016.02.005

Cited by 3 publications

(15 citation statements)

References 17 publications

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“…The efficacy of FG has been shown in many previous studies (Fullum et al, 2009;Raptis et al, 2018;Senol et al, 2013;Vakalopoulos et al, 2017a;Wu et al, 2015). While experimental and retrospective studies have shown negative effects of HIPEC on colon anastomoses, others have reported positive effects for the fibrin glue on colorectal anastomosis following HIPEC (Aghayeva et al, 2017;Piso et al, 2019;Raptis et al, 2018;Torres-Melero et al, 2016). Buen et al (Portilla-de Buen et al, 2014) showed a positive effect of the fibrin glue on bursting pressure in an ischemic left colon anastomosis model, while Fullum et al (Fullum et al, 2009) suggested a possible reduced risk of leakage with the use of FG in the anastomosis and stapler lines, following laparoscopic Roux-en-Y gastric bypass.…”

Section: Discussionmentioning

confidence: 87%

“…Although a variety of surgical techniques, drugs, and adhesion barriers have been utilized in experimental studies of colonic anastomoses, no ideal algorithms for the prevention of anastomotic leaks have been established until now (Aghayeva et al, 2017;Daglioglu et al, 2018;Demiryas et al, 2019;Raptis et al, 2018;Senol et al, 2013;Torres-Melero et al, 2016;Vakalopoulos et al, 2017a). Advances in technology have allowed the introduction of adhesion barriers in a wide spectrum of procedures (Vakalopoulos et al, 2017a).…”

Section: Discussionmentioning

confidence: 99%

“…Advances in technology have allowed the introduction of adhesion barriers in a wide spectrum of procedures (Vakalopoulos et al, 2017a). Despite the confirmed efficacy of adhesion barriers, the ideal molecule, particularly for the lower gastrointestinal system, has not been defined (Daglioglu et al, 2018;Fullum et al, 2009;Raptis et al, 2018;Senol et al, 2013;Torres-Melero et al, 2016;Vakalopoulos et al, 2017aVakalopoulos et al, , 2017bWu et al, 2015). An ideal barrier should have certain characteristics such ease of preparation, low cost, sterility, pliability, biochemical inertness and harmlessness, and minimal or no inflammatory properties as well as causing no adhesions or infections.…”

Section: Discussionmentioning

confidence: 99%

“…Their effects have also been tested in a number of studies involving lower gastrointestinal procedures, although they are not used in clinical practice. While fibrin glue (FG) is one of the most frequently investigated agents in experimental studies of colonic anastomosis (Aghayeva et al, 2017;Daglioglu, Duzgun, Sarici, & Ulutas, 2018;Raptis et al, 2018;Senol et al, 2013;Torres-Melero, Motos-Mico, Lorenzo-Linan, Morales-Gonzalez, & Rosado-Cobian, 2016;Vakalopoulos et al, 2017a), Duraseal® has also been subject to some research (Karagoz Avci et al, 2011;Wu et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Effects of Duraseal® and Fibrin Glue on healing of normal and ischemic colon anastomosis

Kara¹,

Ulualp²

2020

IJP

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Background and Aims: Anastomotic leaks represent a major complication of colorectal surgery. This study, involving a rat model of normal and ischemic colon anastomosis, aims to compare the effects of Duraseal® with those of Fibrin Glue (FG). Methods: Fifty adult male Wistar Albino rats were divided into six groups; normal colon anastomosis, ischemic colon anastomosis, FG on normal colon anastomosis, Duraseal® on normal colon anastomosis, FG on ischemic colon anastomosis, Du-raseal® on ischemic colon anastomosis. After scarification, bursting pressure were measured and samples were collected for histopathological examination and hydroxyproline assays. Results: While the mean bursting pressure was statistically higher in groups treated with Duraseal® when compared to controls (p<0.05), no significant differences between Duraseal® and FG were detected (p>0.05). The mean hydroxyproline level was significantly lower in the Duraseal® groups than in the FG groups (p<0.05). However, significant differences between Duraseal® and control groups were found only in ischemic colon anastomosis (p<0.05). Histopathological examinations did not show any differences in wound healing. Conclusion: Considering the advantages associated with the use of Duraseal®, we may assume that it may play role in gastrointestinal surgery with respect to prevention of anastomotic leaks. However, data is limited, and further studies are warranted to better define its place in surgery.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of Duraseal® and Fibrin Glue on healing of normal and ischemic colon anastomosis

Kara¹,

Ulualp²

2020

IJP

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“…One of the identified studies was for pancreaticoduodenectomy, 28 and one was for esophagojejunal anastomosis, 18 while the other 16 studies were for different procedures in the upper colorectum, including anal fistula repairs and laparoscopic gastric bypass surgeries. 1,2,7,10,[13][14][15][16]19,26,27,32,36,37,40,41,44 Many of these studies suggest a relationship between FS and a reduction in leakages and other complications such as bleeding. However, these studies were not powered to find statistical significance in results.…”

Section: Discussionmentioning

confidence: 99%

<p>Costs Analysis of Fibrin Sealant for Prevention of Anastomotic Leakage in Lower Colorectal Surgery</p>

Panda

Connolly²,

Ramírez³

et al. 2020

RMHP

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Introduction: Postoperative anastomotic leaks remain a common and serious complication of colorectal surgeries and are a major cause of mortality and morbidity of these procedures. Anastomotic leaks (AL) have been extensively studied; however, there has been no significant reduction in their prevalence over time. In addition, there is a significant economic burden from AL attributed to the need for repeat surgery, radiologic intervention and lengthened hospital stay. We conducted a comparative cost analysis of patients undergoing colorectal surgery with anastomosis, with the application of fibrin sealant (FS) to the sutured anastomosis versus not treating the sutured anastomosis with FS. Methods: The deterministic decision-tree model was populated with clinical data including operating room time, hospitalization days, occurrence of AL, need for revision surgery, blood products and radiologic interventions to treat the AL in lower colorectal surgery. A systematic literature review was conducted to identify appropriate studies with these variables. Results: The average cost per case treated lower colorectal surgery with fibrin sealant glue 10 mL Tisseel ® and those not treated with a fibrin sealant after suturing the anastomoses was €3233 and €4130, respectively, for resource expenses paid by the healthcare system. This would suggest potential savings of €897 per surgery, achieved through the application of FS to the sutured anastomosis for preventing AL following colorectal surgery. Conclusion: Application of FS to the sutured anastomosis in lower colorectal surgery resulted in a decrease in post-operative AL, and cost savings based on a reduction in hospitalization days, a reduction needing: revision surgery, radiologic intervention and blood products to treat AL.

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Coating of Intestinal Anastomoses for Prevention of Postoperative Leakage: A Systematic Review and Meta-Analysis

et al. 2022

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BackgroundFor several decades, scientific efforts have been taken to develop strategies and medical aids for the reduction of anastomotic complications after intestinal surgery. Still, anastomotic leakage (AL) represents a frequently occurring postoperative complication with serious consequences on health, quality of life, and economic aspects. Approaches using collagen and/or fibrin-based sealants to cover intestinal anastomoses have shown promising effects toward leak reduction; however, they have not reached routine use yet. To assess the effects of covering intestinal anastomoses with collagen and/or fibrin-based sealants on postoperative leakage, a systematic review and meta-analysis were conducted.MethodPubMed, Web of Science, Cochrane Library, and Scopus (01/01/1964 to 17/01/2022) were searched to identify studies investigating the effects of coating any intestinal anastomoses with collagen and/or fibrin-based sealants on postoperative AL, reoperation rates, Clavien–Dindo major complication, mortality, and hospitalization length. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.ResultsOverall, 15 studies (five randomized controlled trials, three nonrandomized intervention studies, six observational cohort studies) examining 1,387 patients in the intervention group and 2,243 in the control group were included. Using fixed-effects meta-analysis (I2 < 50%), patients with coated intestinal anastomoses presented significantly lower AL rates (OR = 0.37; 95% CI 0.27–0.52; p < 0.00001), reoperation rates (OR, 0.21; 95% CI, 0.10–0.47; p = 0.0001), and Clavien–Dindo major complication rates (OR, 0.54; 95% CI, 0.35–0.84; p = 0.006) in comparison to controls, with results remaining stable in sensitivity and subgroup analyses (stratified by study design, age group, intervention used, location of anastomoses, and indication for surgery). The length of hospitalization was significantly shorter in the intervention group (weighted mean difference (WMD), −1.96; 95% CI, −3.21, −0.71; p = 0.002) using random-effects meta-analysis (I2 ≥ 50%), especially for patients with surgery of upper gastrointestinal malignancy (WMD, −4.94; 95% CI, −7.98, −1.90; p = 0.001).ConclusionThe application of collagen-based laminar biomaterials or fibrin sealants on intestinal anastomoses can significantly reduce postoperative rates of AL and its sequelae. Coating of intestinal anastomoses could be a step toward effective and sustainable leak prevention. To assess the validity and robustness of these findings, further clinical studies need to be conducted.

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Use of absorbable fibrin sealant patch to strengthen the gastrointestinal anastomosis performed on patients with peritoneal carcinomatosis treated with intention to cure by debulking surgery and intraoperative hyperthermic intraperitoneal chemotherapy

Cited by 3 publications

References 17 publications

Effects of Duraseal® and Fibrin Glue on healing of normal and ischemic colon anastomosis

Effects of Duraseal® and Fibrin Glue on healing of normal and ischemic colon anastomosis

<p>Costs Analysis of Fibrin Sealant for Prevention of Anastomotic Leakage in Lower Colorectal Surgery</p>

Coating of Intestinal Anastomoses for Prevention of Postoperative Leakage: A Systematic Review and Meta-Analysis

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