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

• Published in: 世界胃肠外科杂志：英文版（电子版） 2016 (9), p.627-633
• Main Author: 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
• Format: Article
• Language: English
• Subjects: Colon; Rats; Anastomosis; Leak; TachoSil~?; Surgery
• ISSN: 1948-9366; 1948-9366

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 Tacho Sil? 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.