Publication: Histopathological changes associated to an absorbable fibrin patch (Tachosil®) covering in an experimental model of high-risk colonic anastomoses
Authors
García Vásquez, C. ; Gómez García de las Heras, S. ; Pastor Idoate, C. ; De Pablo, D. ; Fernández Aceñero, M.J.
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Publisher
Universidad de Murcia. Departamento de Biología Celular e Histología
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DOI
DOI: 10.14670/HH-11-930
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info:eu-repo/semantics/article
Description
Abstract
Background. TachoSil® is a fibrin sponge
that contains fibrinogen and thrombin and is a useful
adjuvant to enhance control of air leaks in thoracic
surgery and to control bleeding in vascular and general
surgery. Its use in intestinal surgery to prevent suture
dehiscence is currently under investigation.
Material and Methods. We report the results of a
prospective randomized experimental study on 33 large
white pigs in which a high-risk suture was created by
induction of ischemia. We randomly employed
TachoSil® to cover the anastomosis in half of the
animals compared to a control group of uncovered
anastomosis. After euthanasia, postmortem analysis was
performed describing the findings related to anastomotic
leakage, peritonitis and grade of adhesions. The entire
anastomosis was resected in bloc and sent for
histopathological analysis. A single blinded-pathologist
evaluated the histopathological features of the
specimens.
Results. We found statistically significant
differences favouring the patch in decreasing leakage in
the covered group. The healing process did not show
significant differences between groups, although a
higher rate of microscopic abscess was observed in the
covered group.
Conclusion. The use of fibrin sealants covering highrisk intestinal sutures has a positive effect in avoiding
macroscopic anastomotic leakage. The patch did not
have any influence in the anastomotic healing process,
however, as a result of the effect in containing the
inflammatory response, it may increase the rate of
abscess.
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Citation
Histology and Histopathology, Vol.33, nº3, (2018)
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