title: Circulating cytokines in patients undergoing tonsillectomy with fibrin glue.
abstract: OBJECTIVE
  Fibrin glue is used as a haemostatic agent or as a sealant. The aim of this study is to objectively evaluate the efficacy of the use of fibrin glue Quixil - a human surgical sealer - in tonsillectomy, for the reduction of post-operative inflammatory response.
  
  
  METHODS
  A prospective randomized single-blind study.
  
  
  METHODS
  The study was performed on 40 consecutive patients undergoing adenotonsillectomy (T&A). Patients were randomly assigned to one of two sub-groups: a study group and a control group. The tonsillar beds of patients in the study group were coated with fibrin glue (Quixil, OMRIX biopharmaceuticals) at the end of the operation; the patients in the control group were treated for hemostasis without the use of fibrin glue. Complete blood counts and circulating pro-inflammatory cytokines (assayed by specific immunoassay - ELISA) were assessed in samples drawn pre- and 16 h post-tonsillectomy.
  
  
  RESULTS
  Forty patients (aged 5.8 ± 2.4 years) were consecutively enrolled; 45% (18) of the patients were treated with fibrin glue, 55% (22) were not. Compared to controls, Quixil-treated patients demonstrated a reduction in post-tonsillectomy circulating leukocytes (29.2% vs. 45.4%, p<0.05), neutrophiles (28.3% vs. 42.1%, p<0.05), IL-6 (+1% vs. +42%, p<0.05), and TNF-alpha (+8% vs. +26%, p<0.05.
  
  
  CONCLUSIONS
  Intra-operative fibrin glue therapy is associated with decreased immediate inflammatory response following T&A. Further studies are warranted to assess long-term outcome.
  
  
  METHODS
  1B.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. lirant1@gmail.com
authors.forename: L
authors.initials: L
authors.lastname: Stiller-Timor
authors.forename: A D
authors.initials: AD
authors.lastname: Goldbart
authors.forename: N
authors.initials: N
authors.lastname: Segal
authors.forename: A
authors.initials: A
authors.lastname: Amash
authors.forename: M
authors.initials: M
authors.lastname: Huleihel
authors.forename: A
authors.initials: A
authors.lastname: Leiberman
authors.forename: A
authors.initials: A
authors.lastname: Tal
authors.forename: G
authors.initials: G
authors.lastname: Holcberg
authors.forename: M
authors.initials: M
authors.lastname: Puterman
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D011446:Prospective Studies; D016037:Single-Blind Method; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000473:pathology / Q000601:surgery; D014068:Tonsillectomy / Q000009:adverse effects*; D014069:Tonsillitis / Q000097:blood* / Q000473:pathology / Q000601:surgery; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D015718:Fibrin Tissue Adhesive; D006490:Hemostatics; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha