Endoscopic injection of human fibrin sealant in treatment of intrathoracic anastomotic leakage after esophageal cancer surgery

Abstract

Objective To investigate the application of endoscopic injection of human fibrin sealant in treatment of patients with intrathoracic anastomotic leakage after esophagectomy. Methods A total of 179 patients who underwent intrathoracic anastomosis after esophageal cancer surgery in our department From December 2012 to May 2015 were retrospectively analyzed. The clinical data and treatment of 7 patients with postoperative intrathoracic anastomotic leakage were analyzed and discussed. On Day 28 after operation, the 7 patients were given endoscopic injection of human fibrin sealant to seal the anastomotic leakage, and the changes in drainage volume, body temperature, CRP, white blood cell count and other indicators were compared before and after endoscopic intervention. Results After endoscopic injection of human fibrin sealant in all 7 patients with intrathoracic anastomotic leakage, the volume of para-anastomotic drainage, CRP, and WBC count were improved compared with those before treatment. Relevant data were analyzed, and the differences were statistically significant (P = 0.019, P = 0.001, P = 0.014, respectively). No statistically significant difference was observed in the body temperature before and after treatment (P = 0.217). Conclusion For patients with intrathoracic anastomotic leakage after esophageal cancer surgery, endoscopic injection of human fibrin sealant to seal the anastomotic leakage has positive therapeutic effects of reducing exudation around the anastomotic leakage, reducing systemic inflammatory response, and improving clinical symptoms including dysphagia, weight loss without trying, chest pain, pressure or burning, worsening indigestion or heartburn and coughing or hoarseness.

Coating of Intestinal Anastomoses for Prevention of Postoperative Leakage: A Systematic Review and Meta-Analysis

“…On the downside of the ambiguous outcomes presented in different experimental animal studies ( 22 – 31 , 33 , 59 , 60 ), fibrin sealants have been utilized already in human trials, showing positive effects. Sealing postoperatively occurring anastomotic leaks of the upper and lower GIT with fibrin sealants endoscopically has been conducted with successful therapeutic outcomes ( 61 – 63 ). Endoscopic applications have shown to reduce exudation from the leakage site, systemic inflammatory response, and clinical symptoms of treated patients ( 61 ) and seem to serve as an efficient and safe option to manage postoperative ALs ( 62 ).…”

Treatment of corneal dermoid with fibrin glue boned multi-layer lenticules derived from SMILE surgery

“…Fibrin glue (FG) is a new blood-derived product, which had been widely used in many surgical operations for its character of adhesion, blocking, sealing, covering, strengthening, lling and preventing wound hemostasis [13][14][15] . The safety and bene ts of FG had also been proved in some ophthalmic surgeries, such as amniotic membrane (AM) transplantation, pterygium or strabismus surgery, and even vitreoretinal or cataract surgeries [16][17][18][19] .…”

Human umbilical cord mesenchymal stem cells: Heralding an effective treatment against esophageal cancer?

“…The etiology of this illness has not been completely illustrated, but some risk factors have been introduced, such as alcohol consumption, smoking, high body mass index (BMI), and dietary agents (high nitrite levels, nitrosamine consumption, and high nitrite levels; J. Li et al, 2021; Tétreault, 2015). Some symptoms associated with EC include weight loss without trying, dysphagia, chest pain, burning or pressure, hoarseness, or coughing (X. Chen et al, 2020). For treating EC, some common options comprise chemotherapy, surgery, and radiotherapy (X. Li et al, 2021).…”

“…Some symptoms associated with EC include weight loss without trying, dysphagia, chest pain, burning or pressure, hoarseness, or coughing (X. Chen et al, 2020). For treating EC, some common options comprise chemotherapy, surgery, and radiotherapy (X. .…”