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A Journal on Surgery
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,877
Minerva Chirurgica 2011 June;66(3):183-8
Enteric anastomosis and Tachosil®
De Stefano A., Bettarini F., Di Mare G., Neri A. ✉
Unità di Chirurgia Generale ed Oncologica, Dipartimento di Patologia e Oncologia Umana, Università di Siena, Siena, Italy
AIM: Anastomotic leakage is a common complication of colorectal surgery. To date, no clinical study exists showing a significant effect in reducing its frequency by sealing the anastomosis with a fibrin glue-coated collagen patch; the aim of this study was to demonstrate the efficacy of Tachosil®.
METHODS: We considered patients undergoing open resective colorectal surgery. In selected cases, the Tachosil® patches were wrapped around the anastomotic line. The onset of anastomotic leakage was either defined clinically and investigated by contrast enema and CT scan.
RESULTS: From January 2010 to February 2011, 63 patients underwent colorectal surgery at our Institute. Tachosil® was used in 24 cases. We recorded six major surgical complications; all complicated cases were in the no-Tachosil® group. A shorter mean postoperative stay of 7.2 days was observed for patients where Tachosil® was applied compared to 9.3 days for patients of no- Tachosil® group. These difference was mainly related to anastomotic insufficiencies recorded in the no-Tachosil®, group. Fibrin-coated collagen glue is used in different fields of surgery to improve hemostasis and anastomotic healing. Our experience confirmed its safety with a low incidence of anastomotic leak. These experience is based on few, non-randomized cases and therefore cannot demonstrate a real efficacy of Tachosil® in anastomotic leak prevention.
CONCLUSION: Anastomotic leakage is a relatively common and potentially catastrophic complication after gastrointestinal surgery. Our initial experience with Tachosil® has confirmed the safety of this patch and we can therefore suggest a possible positive effect on anastomotic healing.