Early effects of fibrin sealant on colonic anastomosis in rats: an experimental and case-control study.
BACKGROUND
Leakage from colonic anastomoses leads to mortality and morbidity. Fibrin adhesives can be used to increase the strength of the anastomosis. In this study, we evaluated the early effects of fibrin sealant and hyaluronic acid-carboxymethylcellulose on colonic anastomosis in rats.


METHODS
Anastomoses were made in the descending colon of 38 female Wistar-Albino rats, in three groups: control group (n = 12), group 1 treated with hyaluronic acid-carboxymethylcellulose (n = 16), and group 2 treated with fibrin sealant (n = 10). After 72 hours, adhesion scores, bursting pressure, rupture strength and histopathologic healing scores were evaluated.


RESULTS
Due to postoperative mortality, we evaluated 10, 10 and 9 rats in the control group and in groups 1 and 2, respectively. Of these, we excluded 4, 5 and 4 rats that had macroperforations at autopsy. In the remaining rats, bursting pressure (123.2 +/- 14.8 mmHg) and rupture strength (400 +/- 16 mg) in the fibrin sealant group were significantly greater than in the two other groups (


METHODS
68.0 +/- 10.6 p = 0.006 and 325 +/- 52 p = 0.009; Group 1: 74.0 +/- 9.8 p = 0.03, 330 +/- 27 p = 0.016). However, we did not observe any significant difference between adhesion scores (2.5 +/- 0.6, 2.0 +/- 0.7, 2.0 +/- 0.7, p = 0.343).


CONCLUSIONS
In this experimental study, fibrin sealant increased bursting pressure and rupture strength of colonic anastomoses while hyaluronic acid-carboxymethylcellulose had no effects in rats, but both of them showed no effect on adhesion scores. In order to use fibrin sealant to decrease the rate of early leakages from colonic anastomoses, further studies have to be performed.
Akgün
A
A
Second Department of Surgery, Ankara Training and Research Hospital Ministry of Health, Ankara, Turkey.
Kuru
S
S
Uraldi
C
C
Tekin
O
O
Karip
B
B
Tug
T
T
Ongören
A U
AU
D000714:Anastomosis, Surgical; D000818:Animals; D002266:Carboxymethylcellulose Sodium / Q000627:therapeutic use; D003106:Colon / Q000601:surgery*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006820:Hyaluronic Acid / Q000627:therapeutic use; D011312:Pressure; D051381:Rats; D017208:Rats, Wistar; D000267:Tissue Adhesions / Q000209:etiology; D014014:Tissue Adhesives / Q000627:therapeutic use*
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium