[Endoscopic treatment of intestinal anastomotic leakage in low anterior resection of the rectum by using fibrin adhesive. Our experience].
BACKGROUND
Personal experience about treatment of anastomotic leakage in low anterior resection of the rectum by using human fibrin adhesive "Tissucol" is reported.


METHODS
Eight cases of anastomotic leakage treated with using human fibrin adhesive "Tissucol", are analyzed in a retrospective study. Patients had three/six months-one year follow up. Treatment with human fibrin adhesive "Tissucol" was performed in our Endoscopic ambulatory. Six cases had either an immediate resolution or an ambulatorial follow-up; in 2 cases only, general complications forced to a prolonged hospital stay. The study concerns 58 patients subjected to low anterior resection of the rectum and endoscopic treatment of 8/58 patients with anastomotic leakage. Fistulas were sealed with human fibrin adhesive "Tissucol" by using flexible endoscope. Anastomotic leakage identification leakage was made and low anterior resection of the rectum and sealing with human fibrin adhesive "Tissucol" were performed.


RESULTS
Complete sealing of fistula and rectum patent.


CONCLUSIONS
The excellent results obtained with this non invasive and fast treatment, easily practicable even in ambulatorial regimen, lead the authors to consider it effective and as first-choice treatment of this dangerous complication. The cost/benefit ratio is favorable if compared with the long hospital stay required for other treatments, which also present loaded high morbidity and mortality.
Testi
W
W
Istituto di Chirurgia Generale e Specialità Chirurgiche, Università degli Studi di Siena, Siena, Italy.
Vernillo
R
R
Spagnulo
M
M
Genovese
A
A
Picchianti
D
D
Stefanoni
M
M
Terreni
C
C
Lorenzi
M
M
De Martino
A
A
Mancini
S
S
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D000714:Anastomosis, Surgical; D003108:Colonic Diseases / Q000209:etiology / Q000628:therapy; D015179:Colorectal Neoplasms / Q000601:surgery; D003362:Cost-Benefit Analysis; D017558:Elective Surgical Procedures; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000191:economics / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007412:Intestinal Fistula / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016562:Parenteral Nutrition, Home Total; D011183:Postoperative Complications / Q000628:therapy*; D012003:Rectal Fistula / Q000209:etiology / Q000628:therapy; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D012812:Sigmoidoscopy; D013529:Surgical Wound Dehiscence / Q000453:epidemiology / Q000628:therapy*; D014014:Tissue Adhesives / Q000191:economics / Q000627:therapeutic use*; D016896:Treatment Outcome
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives