title: Anastomotic leakage after laparoscopic resection of rectal cancer: the impact of fibrin glue.
abstract: BACKGROUND
  The aim of this study was to evaluate whether the use of fibrin glue as a sealant over an anastomosis is a risk factor for anastomotic leakage after laparoscopic rectal cancer surgery.
  
  
  METHODS
  Prospective data were collected from 223 patients with rectal cancer who underwent laparoscopic resection without defunctioning stoma.
  
  
  RESULTS
  A total of 104 patients underwent laparoscopic rectal resection, followed by the application of fibrin glue over the stapled anastomosis, while 119 underwent surgery alone. No difference in clinically significant leakage was observed between the fibrin and the nonfibrin groups (5.8% vs 10.9%, P = .169). In multivariate analysis, extraperitoneal tumor location and operation duration >220 minutes were independently associated with anastomotic leakage.
  
  
  CONCLUSIONS
  Significant predictors of anastomotic leakage include extraperitoneal tumor location and operation length >220 minutes. Fibrin glue application over the stapled anastomosis was not found to be significantly associated with anastomotic leakage.
authors.affiliation: Department of Surgery, Chonnam National University, Hwasun Hospital and Medical School, Gwangju, Korea.
authors.forename: Jung Wook
authors.initials: JW
authors.lastname: Huh
authors.forename: Hyeong Rok
authors.initials: HR
authors.lastname: Kim
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016017:Odds Ratio; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012307:Risk Factors; D013528:Surgical Staplers; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000628:therapy*; D013997:Time Factors; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives