Fibrin sealants as an adequate treatment alternative to traditional suturing for confined bowel lesions: A hypothesis for future experimental research

Frountzas, Maximos; Pergialiotis, Vasilios; Stergios, Konstantinos; Doulamis, Ilias P.; Katafygiotis, Patroklos; Lazaris, Andreas C.; Schizas, Dimitrios; Perrea, Despina; Nikiteas, Nikolaos; Toutouzas, Konstantinos

doi:10.1016/j.mehy.2019.109514

Cited by 2 publications

(1 citation statement)

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“…Consequently, the need of safe and efficient alternatives to sutures in order to repair confined bowel lesions during laparoscopic procedures has been raised. TISSEEL TM , a biocompatible agent that simulates the final stages of coagulation cascade, has been proposed as an option [31]. Our study demonstrated that TISSEEL TM provides almost complete tissue regeneration with less inflammation and fibrosis compared to the conventional suturing technique for the repair of bowel perforations ≤2 mm.…”

Section: Discussionmentioning

confidence: 69%

The Effect of TISSEELTM on Confined Bowel Perforation: An Experimental Study

et al. 2021

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Objective: During the last decades, surgeons of several specialties presenting different levels of expertise in colon handling have been involved in laparoscopic procedures. The aim of the present experimental study was to investigate the feasibility of TISSEELTM versus the conventional suture placement technique on confined bowel lesions in rats. Methods: Twenty-four Sprague-Dawley rats underwent confined bowel perforation and were divided into three groups: the SUTURE group (sutures were used), the SUTURE + TISSEELTM group (sutures and TISSEELTM were utilized), and the TISSEELTM group (only TISSEELTM was used). Blinded histopathologic analysis followed animal sacrifice. Results: The median weight of the rats was 526 ± 50 g. A single animal had hematochezia on the first postoperative day. Cessation of bleeding at the perforation margin was indicated intraoperatively after TISSEELTM application. Animals in the TISSEELTM group presented less intraperitoneal adhesions and lower hemorrhagic infiltration compared to animals of the two other groups. In addition, animals in the TISSEELTM group showed thrombus formation at the bowel perforation site compared to animals of the two other groups (p = 0.042). Histopathologic analysis demonstrated reduced inflammatory reaction (p = 0.003), diminished fibrosis (p = 0.001), and better tissue regeneration (p = 0.000) in the TISSEELTM group compared to the other two groups. Conclusion: Application of TISSEELTM at the perforation site was associated with increased regeneration of the intestinal wall and less inflammatory and fibrotic reaction compared to suture placement. However, more experimental and clinical studies should be conducted before implementation in humans.

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Section: Discussionmentioning

confidence: 69%