title: [Use of absorbable fibrin sealant patch to strengthen the gastrointestinal anastomosis performed on patients with peritoneal carcinomatosis treated with intention to cure by debulking surgery and intraoperative hyperthermic intraperitoneal chemotherapy].
abstract: BACKGROUND
  Peritoneal disseminated disease, regardless of its origin, should currently be considered a locoregional disease stage, and thus a candidate for an intention to treat therapeutic option with debulking surgery and hyperthermic intraperitoneal chemotherapy.
  
  
  OBJECTIVE
  To determine whether or not the collagen sponge with fibrinogen 5.5mg and thrombin 2IU, applied as a tissue sealant and gastrointestinal reinforcement sutures, contributes to the reduction of anastomotic leak.
  
  
  METHODS
  Quasi-experimental, comparative, prospective, case/control study conducted on patients with peritoneal carcinomatosis of colorectal origin, operated on in our Peritoneal Cancer Surgery Unit from 2011 to April 2014. The study included 73 patients, 43 (59%) men and 30 (41%) women with peritoneal carcinomatosis of colorectal origin, candidates for debulking surgery and hyperthermic intraperitoneal chemotherapy. Gastrointestinal anastomoses were performed on 49 (67%) patients. These patients were randomised into 2 groups: A control (27) and B hypothesis (22) reinforced with sponge suture.
  
  
  RESULTS
  The total number of anastomoses performed was 49 (mean: 1.9), with 27 in the control group A (mean: 1.88) and 22 in B (mean: 2.16). The debulkings achieved were: complete debulking 0.38 (77.5%), complete debulking 1: 7 (14.8%), and 4 (8.1%) did not undergo hyperthermic intraperitoneal chemotherapy due to complete debulking>2. Intestinal fistula: 3 cases (6.1%) in A group vs 0 in B.
  
  
  CONCLUSIONS
  In our series, the use of a fibrinogen and thrombin sponge has contributed to a significant reduction in the risk of gastrointestinal fistulas in high risk oncology patients.
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Torrecárdenas, Almería, España.
authors.forename: Juan
authors.initials: J
authors.lastname: Torres-Melero
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Torrecárdenas, Almería, España. Electronic address: jacob_motos@hotmail.com.
authors.forename: José Jacob
authors.initials: JJ
authors.lastname: Motos-Micó
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Torrecárdenas, Almería, España.
authors.forename: Miguel
authors.initials: M
authors.lastname: Lorenzo-Liñán
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Torrecárdenas, Almería, España.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Morales-González
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Torrecárdenas, Almería, España.
authors.forename: Rafael
authors.initials: R
authors.lastname: Rosado-Cobián
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000517:prevention & control; D001672:Biocompatible Materials; D002277:Carcinoma / Q000628:therapy*; D016022:Case-Control Studies; D010478:Chemotherapy, Cancer, Regional Perfusion; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures; D005260:Female; D015718:Fibrin Tissue Adhesive; D006801:Humans; D006979:Hyperthermia, Induced; D007422:Intestines / Q000601:surgery; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000628:therapy*; D011446:Prospective Studies
chemical_list: D001672:Biocompatible Materials; D015718:Fibrin Tissue Adhesive
keywords: Absorbable fibrin sealant patch; Anastomosis intestinal; Carcinomatosis; Cirugía citorreductora; Debulking surgery; Esponja de colágeno con fibrinógeno; Intestinal anastomosis