title: Canine colonic anastomoses reinforced with dye-enhanced fibrinogen and a diode laser.
abstract: Leakage from colonic anastomoses is a common cause of morbidity in patients recovering from bowel surgery. We evaluated a technique of laser-fibrinogen reinforcement to strengthen colonic anastomoses in a canine model. After creation of eight single-layer interrupted suture anastomoses in six dogs, indocyanine green-dye-enhanced fibrinogen was topically applied to the serosal surface and exposed to 808 nm diode laser energy. Immediately following colonic anastomosis, the mean leakage pressure was 137 +/- 22 mm Hg in the group (n = 8) using sutures alone and 326 +/- 67 mm Hg (P less than 0.001) in the group (n = 8) after the sutured anastomosis was reinforced with lasered-fibrinogen. On histological examination, no evidence of thermal injury to the tissue edges was noted and a layer of fibrinogen bridged the anastomotic gap. Laser dye-enhanced fibrinogen reinforcement significantly enhances the strength of sutured colonic anastomoses without causing appreciable thermal injury to the host tissues.
authors.affiliation: Department of Surgery, Columbia University College of Physicians & Surgeons, New York, New York.
authors.forename: S K
authors.initials: SK
authors.lastname: Libutti
authors.forename: M C
authors.initials: MC
authors.lastname: Oz
authors.forename: K A
authors.initials: KA
authors.lastname: Forde
authors.forename: J S
authors.initials: JS
authors.lastname: Auteri
authors.forename: J P
authors.initials: JP
authors.lastname: Johnson
authors.forename: L S
authors.initials: LS
authors.lastname: Bass
authors.forename: M R
authors.initials: MR
authors.lastname: Treat
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D003106:Colon / Q000601:surgery*; D004285:Dogs; D005340:Fibrinogen; D007208:Indocyanine Green; D053685:Laser Therapy / Q000379:methods*; D011312:Pressure
chemical_list: D005340:Fibrinogen; D007208:Indocyanine Green