title: Efficacy of Human Fibrinogen-Thrombin Patch (TachoSil) Clinical Application in Upper Gastrointestinal Cancer Surgery.
abstract: BACKGROUND
  Previous studies investigated the efficacy and applicability of tissue adhesives in gastrointestinal surgery while no evidence is available to date about a novel compound, TachoSil (Takeda, Zurich, Switzerland). The primary aim of this observational study was to assess the effect of new fibrin sealant on the incidence of postoperative complications in a homogeneous group of patients submitted to upper gastrointestinal surgery for cancer.
  
  
  METHODS
  Two cohorts of 28 and 34 patients undergoing upper gastrointestinal for surgery were compared. In the first cohort, the anastomotic site was treated with TachoSil fibrinogen-thrombin-collagen patches and in the second no collagen sponge or any other hemostatic sealant was used. Postoperative complications and outcomes as well as postoperative biochemical parameters were analyzed.
  
  
  RESULTS
  Postoperative complications occurred in 12 patients (35.3%) and 2 patients (7.1%) in control and collagen sponge group respectively (χ2= 3.539, p < 0.05), with no anastomotic leakage in the collagen sponge group. A binary logistic regression analysis showed that the nonuse of collagen sponge [odds ratio (OR) = 0.025, 95% confidence interval (CI) = 0.001-0.457, p = 0.01] was independently associated with postoperative complication occurrence.
  
  
  CONCLUSIONS
  The addition of fibrinogen-thrombin-collagen sponge patch may reduce postoperative complication rate after upper gastrointestinal surgery for cancer. Further study to delineate the role of TachoSil in gastrointestinal surgery are also needed to demonstrate improved effectiveness and applicability.
authors.affiliation: a 8th General and Gastrointestinal Surgery -Department of Internal Medicine, Surgical , Neurological Metabolic Disease and Geriatric Medicine - Second University of Naples , Naples , Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Marano
authors.affiliation: a 8th General and Gastrointestinal Surgery -Department of Internal Medicine, Surgical , Neurological Metabolic Disease and Geriatric Medicine - Second University of Naples , Naples , Italy.
authors.forename: Natale
authors.initials: N
authors.lastname: Di Martino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005340:Fibrinogen / Q000008:administration & dosage*; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D013274:Stomach Neoplasms / Q000601:surgery; D015503:Surgical Sponges; D013917:Thrombin / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D005340:Fibrinogen; D013917:Thrombin
keywords: Gastrointestinal surgery; TachoSil; anastomosis; anastomotic leak; fibrin sealants; fibrin tissue adhesive