Anastomotic Leakage Using Linear Stapling Device with Pre-attached Bioabsorbable Polyglycolic Acid Felt After Laparoscopic Anterior Resection

Yamamoto, Seiichiro; Kanai, Tatsuaki; Osumi, Koji; Yo, Kikuo; Takano, Kiminori; Tsutsui, Mai; Nakanishi, Ryota; Yoshikawa, Yutaka; Kaneko, Yasushi; Nakagawa, Motohito

doi:10.21873/anticanres.12181

Cited by 8 publications

(9 citation statements)

References 5 publications

(7 reference statements)

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“…However, that study contained a small proportion of patients with a high risk of bleeding (5% of patients took antithrombotics and 31% of patients showed resected specimen size $40 mm), hindering the comparability of the findings. We considered alternative studies using fibrin glue with a PGA sheet to calculate sample size (19,20,29,30), assuming that the preventive effect on post-ESD bleeding was mainly due to the fibrin glue's hemostatic effect rather than the PGA sheet because PGA sheets have been used as a reinforcing material to prevent anastomotic leakage in surgery (37,38) or perforation in ESD (39,40).…”

Section: Discussionmentioning

confidence: 99%

A Randomized Controlled Trial of Fibrin Glue to Prevent Bleeding After Gastric Endoscopic Submucosal Dissection

Lee

Kim

et al. 2022

Am J Gastroenterol

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INTRODUCTION: This study evaluated the efficacy of fibrin glue for preventing postendoscopic submucosal dissection (ESD) bleeding in high-risk patients for bleeding (expected iatrogenic ulcer size ‡40 mm or receiving antithrombotic therapy). METHODS:A multicenter, open-label, randomized controlled trial was performed at 4 tertiary medical centers in South Korea between July 1, 2020, and June 22, 2022. Patients with gastric neoplasm and a high risk of post-ESD bleeding were enrolled and allocated at 1:1 to a control group (standard ESD) or a fibrin glue group (fibrin glue applied to iatrogenic ulcers after standard ESD). The primary outcome was overall bleeding events within 4 weeks. The secondary outcomes were acute bleeding (within 48 hours post-ESD) and delayed bleeding (48 hours to 4 weeks post-ESD). RESULTS:In total, 254 patients were randomized, and 247 patients were included in the modified intention-totreat population (125 patients in the fibrin glue group and 122 patients in the control group). Overall bleeding events occurred in 12.0% (15/125) of the fibrin glue group and 13.1% (16/122) of the control group (P 5 0.791). Acute bleeding events were significantly less common in the fibrin glue group than in the control group (1/125 vs 7/122, P 5 0.034). Delayed bleeding events occurred in 11.2% (14/ 125) in the fibrin glue group and 7.3% (9/122) in the control group (P 5 0.301).

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Section: Discussionmentioning

confidence: 99%

A Randomized Controlled Trial of Fibrin Glue to Prevent Bleeding After Gastric Endoscopic Submucosal Dissection

Lee

Kim

et al. 2022

Am J Gastroenterol

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“…A PGA sheet is a bio-absorbable suture reinforcement material recently reported to be effective for the endoscopic management of gastrointestinal leakage and perforation [ 8 ]. In rectal surgery, PGA has been used to reinforce staple lines and was reported to potentially be effective for reducing anastomotic leakage [ 9 , 10 ]. Therefore, we expected a PGA sheet with fibrin glue to be effective for treating RVF, even though there have been no previous reports of its application for anastomotic leakage after rectal surgery.…”

Section: Discussionmentioning

confidence: 99%

The treatment for refractory rectovaginal fistula after low anterior resection with estriol, polyglycolic acid sheets and primary closure: A case report

Hiraki

Tanaka

Kanai

et al. 2020

International Journal of Surgery Case Reports

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“…The reinforcement cartridge has previously been shown to be effective in preventing air leakage from lung resection margins in respiratory surgery [ 18 ] and dehiscence of staple lines in sleeve gastrectomy in bariatric surgery [ 19 ]. Yamamoto et al [ 20 ] reported a lower incidence rate of AL (1 of 62 cases [1.6%]) with the use of the reinforcement cartridge for rectal transection in rectal surgery. A prospective multicenter observational study to evaluate the efficacy and safety of the reinforcement cartridge for AL (trial ID: UMIN000029543) is also underway in Japan, and the results of this study are awaited.…”

Section: Double Stapling Techniquementioning

confidence: 99%

Optimal anastomotic technique in rectal surgery to prevent anastomotic leakage

Kitaguchi

Ito

2023

Ann Coloproctol

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Complications after colorectal surgery remain inevitable, and anastomotic leakage is one of the most severe and potentially fatal complications. Generally, anastomotic leakage is associated with severe peritonitis, the need for emergency reoperation, and an increased mortality rate. Additionally, particularly after rectal cancer surgery, it has a negative impact on long-term outcomes, including postoperative anorectal function, local recurrence, and survival. To prevent anastomotic leakage, understanding the characteristics of each anastomotic technique and establishing a stable anastomotic procedure are important. Transanal total mesorectal excision (TaTME) is a relatively new advanced surgical access technique for pelvic dissection and facilitates different anastomotic techniques without the need for transabdominal rectal transection. Especially, stapled anastomosis in TaTME, also known as double purse-string circular stapled anastomosis or the single stapling technique (SST), has gained much attention as an alternative to the conventional double stapling technique (DST). In this article, we describe the DST, SST, and hand-sewn anastomosis as anastomotic techniques after rectal surgery, focusing mainly on the differences between conventional anastomotic techniques and SST in TaTME. Furthermore, the blood flow evaluation method for the reconstructive colon before anastomosis, which is extremely important in anastomotic leakage prevention regardless of the anastomotic type, is also described.

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Anastomotic Leakage Using Linear Stapling Device with Pre-attached Bioabsorbable Polyglycolic Acid Felt After Laparoscopic Anterior Resection

Abstract: The frequency of anastomotic leakage was relatively low, and therefore the use of a linear stapler with pre-attached bioabsorbable PGA felt might reduce the risk of adverse events related to anastomosis, especially anastomotic leakage.

Cited by 8 publications

References 5 publications

A Randomized Controlled Trial of Fibrin Glue to Prevent Bleeding After Gastric Endoscopic Submucosal Dissection

A Randomized Controlled Trial of Fibrin Glue to Prevent Bleeding After Gastric Endoscopic Submucosal Dissection

The treatment for refractory rectovaginal fistula after low anterior resection with estriol, polyglycolic acid sheets and primary closure: A case report

Optimal anastomotic technique in rectal surgery to prevent anastomotic leakage

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