Fibrinogen-thrombin collagen patch reinforcement of highrisk colonic anastomoses in rats  

作　　者：Juan Manuel Suárez-Grau Carlos Bernardos García Carmen Cepeda Franco Cristina Mendez García Salud García Ruiz Fernando Docobo Durantez Salvador Morales-Conde Javier Padillo Ruiz 

机构地区：[1]Department of General and Digestive Surgery, Riotinto Hospital, 21660 Huelva, Spain [2]Division of General and Laparoscopic Surgery, Clinic Quiron Sagrado Corazón, 41013 Seville, Spain [3]Institute of Biomedicine of Seville Research center, University Hospital Virgen del Rocio, 41013 Seville, Spain [4]Division of General Surgery, Hospital of San Juan de Dios, 41930 Bormujos, Spain [5]Department of General and Digestive Surgery, University Hospital Virgen del Rocio, 41013 Seville, Spain [6]Department of General surgery, Hospital of Jerez, 11407 Jerez de la Frontera, Cadiz, Spain [7]Division of Surgery, Clinic Quiron Donostia 20012 Donostia, Spain [8]Clinic Quiron Sagrado Corazón,41013 Seville, Spain

出　　处：《World Journal of Gastrointestinal Surgery》2016年第9期627-633,共7页世界胃肠外科杂志（英文版）（电子版）

摘　　要：AIMTo evaluate the effectiveness of human fibrinogen-thrombin collagen patch (TachoSil^®) in the reinforcement of high-risk colon anastomoses.METHODSA quasi-experimental study was conducted in Wistar rats (n = 56) that all underwent high-risk anastomoses (anastomosis with only two sutures) after colectomies. The rats were divided into two randomized groups: Control group (24 rats) and treatment group (24 rats). In the treatment group, high-risk anastomosis was reinforced with TachoSil^® (a piece of TachoSil^® was applied over this high-risk anastomosis, covering the gap). Leak incidence, overall survival, intra-abdominal adhesions, and histologic healing of anastomoses were analyzed. Survivors were divided into two subgroups and euthanized at 15 and 30 d after intervention in order to analyze the adhesions and histologic changes.RESULTSOverall survival was 71.4% and 57.14% in the TachoSil^® group and control group, respectively (P = 0.29); four rats died from other causes and six rats in the treatment group and 10 in the control group experienced colonic leakage (P > 0.05). The intra-abdominal adhesion score was similar in both groups, with no differences between subgroups. We found non-significant differences in the healing process according to the histologic score used in both groups (P = 0.066).CONCLUSIONIn our study, the use of TachoSil^® was associated with a non-statistically significant reduction in the rate of leakage in high-risk anastomoses. TachoSil^® has been shown to be a safe product because it does not affect the histologic healing process or increase intra-abdominal adhesions.AIM To evaluate the effectiveness of human fibrinogenthrombin collagen patch (TachoSil?) in the reinforcement of high-risk colon anastomoses. METHODS A quasi-experimental study was conducted in Wistar rats (n = 56) that all underwent high-risk anastomoses (anastomosis with only two sutures) after colectomies.The rats were divided into two randomized groups:Control group (24 rats) and treatment group (24 rats).In the treatment group, high-risk anastomosis was reinforced with TachoSil? (a piece of TachoSil? was applied over this high-risk anastomosis, covering the gap). Leak incidence, overall survival, intra-abdominal adhesions, and histologic healing of anastomoses were analyzed. Survivors were divided into two subgroups and euthanized at 15 and 30 d after intervention in order to analyze the adhesions and histologic changes.RESULTS Overall survival was 71.4% and 57.14% in the TachoSil? group and control group, respectively (P = 0.29); four rats died from other causes and six rats in the treatment group and 10 in the control group experienced colonic leakage (P > 0.05). The intra-abdominal adhesion score was similar in both groups, with no differences between subgroups. We found non-significant differences in the healing process according to the histologic score used in both groups (P = 0.066). CONCLUSION In our study, the use of TachoSil? was associated with a non-statistically significant reduction in the rate of leakage in high-risk anastomoses. TachoSil? has been shown to be a safe product because it does not affect the histologic healing process or increase intra-abdominal adhesions.

关 键 词：Colon RATS ANASTOMOSIS LEAK TachoSil^®  Surgery 

分 类 号：R656.9[医药卫生—外科学]