Prospective evaluation of omentoplasty in preventing leakage of colorectal anastomosis

Tocchi, A; Mazzoni, Gianluca; Lepre, L; Costa, Gianluca; Liotta, G; Agostini, N; Miccini, Michelangelo

doi:10.1007/bf02237357

Cited by 59 publications

(51 citation statements)

References 18 publications

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“…Unfortunately, many of these attempts have failed to show convincing results [18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48]. Numerous studies have reported on the sealing of gastrointestinal anastomoses with fibrin glue (FG), also called fibrin sealant.…”

Section: Introductionmentioning

confidence: 99%

Fibrin Glue Does Not Improve Healing of Gastrointestinal Anastomoses: A Systematic Review

et al. 2014

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Background/Aim: Anastomotic leakage remains a frequent and serious complication in gastrointestinal surgery. In order to reduce its incidence, several clinical and experimental studies on anastomotic sealing have been performed. In a number of these studies, the sealing material has been fibrin glue (FG), and the results in individual studies have been varying. The positive effect of anastomotic sealing with FG might be due to the mechanical/physical properties, the increased healing of the anastomoses or both. The aim of this systematic review was to evaluate the existing evidence on the healing effects of FG on gastrointestinal anastomoses. Methods: PubMed, EMBASE and the Cochrane databases were searched for studies evaluating the healing process of gastrointestinal anastomoses after any kind of FG application. The search period was from 1953 to December 2013. Results: Twenty-eight studies were included in the qualitative synthesis. These studies were all experimental studies, since no human studies used histological or biochemical evaluation of healing. In 7 of the 28 studies, a positive effect of FG on healing was found, while 8 studies reported a negative effect and 11 studies found no effect. Furthermore, 2 studies reported unclear results. The difference in the study outcome was independent of the study design and the type of FG used. Conclusion: In the available studies, FG did not consistently have a positive influence on the healing of gastrointestinal anastomoses. It is consequently plausible that the positive effect of FG sealing of gastrointestinal anastomoses, if there is any, may be due to a mechanical sealing effect rather than due to improved healing per se.

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Section: Introductionmentioning

confidence: 99%

Fibrin Glue Does Not Improve Healing of Gastrointestinal Anastomoses: A Systematic Review

et al. 2014

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“…In order to prevent leakage postoperatively and to decrease recurrent ureteral obstruction with a progression of residual pelvic malignancy we used a tissue transplant of greater omentum or rectus abdominus muscle [10]. In none of our patients was recurrent ureteral obstruction apparent on follow-up computed tomography.…”

Section: Discussionmentioning

confidence: 91%

“…This was an omental pedicle flap in four and a rectus abdominus muscle flap in one patient [10]. These transplants of highly vascularized tissue to the anastomotic site of the ureters was utilized when possible; they may be of special importance in patients who have had prior radiotherapy.…”

Section: Figmentioning

confidence: 99%

Transureteroureterostomy: an adjunct to the management of advanced primary and recurrent pelvic malignancy

Sugarbaker¹,

Gutman

Verghese³

2003

International Journal of Colorectal Disease

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“…Omentum, peritoneal patches and dura mater have been tested as biological materials [7][8][9][10][15][16][17] . Polyglycolic acid mesh, Dacron, Marlex and artificial collagen or elastin membranes have been evaluated experimentally as synthetic materials [6,7,12,14] .…”

Section: Discussionmentioning

confidence: 99%

“…Covering of gastrointestinal anastomoses by materiminatory systemic consequences of anastomotic dehiscence appears to be a promising approach for the prevention of anastomotic leakage. In the literature, various biological and artificial materials have been studied for anastomotic reinforcement [6][7][8][9][10][11][12][13][14][15][16][17] . Bio-Gide (BG) is a novel biodegradable non-cross-linked collagenous matrix extracted from porcine dermis, which is ultrastructurally characterized by two different surface structures on both sides of the membrane.…”

Section: Introductionmentioning

confidence: 99%

Reinforcement of Colonic Anastomoses with a Collagenous Double-Layer Matrix Extracted from Porcine Dermis

Hoeppner¹,

Willa²,

Timme

et al. 2010

Eur Surg Res

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Background: Anastomotic leakage is a major factor for morbidity in colorectal surgery. Anastomotic reinforcement with biological or synthetic materials has been claimed to be useful in preventing anastomotic leakage. Methods: We evaluated a non-cross-linked collagenous matrix Bio-Gide® (BG) for sealing colonic anastomoses in a rodent model. The animals were investigated for 4, 30 and 90 days. Macroscopic examination, histological examination and measurement of bursting pressure were performed. The anastomotic stricture rate was evaluated by radiographic contrast enema. Results: Microscopically anastomoses sealed by BG showed impaired anastomotic healing. Blood vessel ingrowth and collagen deposition were decreased without reaching significance after 4 days. The anastomotic bursting pressure was significantly decreased (p = 0.0454) in the early phase of healing. Anastomotic neovascularization was significantly decreased compared to the control group after 30 (p = 0.0058) and 90 days (p = 0.0275). Although no difference in anastomotic stricture rate was evident, the rate of intra-abdominal adhesions was significantly increased after 30 (p = 0.0124) and 90 days (p = 0.0281). Conclusion: BG failed to improve colonic anastomotic healing. Early anastomotic healing was impaired if anastomoses were reinforced with BG. BG did not affect the anastomotic stricture rate for up to 3 months; nevertheless, intra-abdominal adhesions were increased.

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Prospective evaluation of omentoplasty in preventing leakage of colorectal anastomosis

Cited by 59 publications

References 18 publications

Fibrin Glue Does Not Improve Healing of Gastrointestinal Anastomoses: A Systematic Review

Fibrin Glue Does Not Improve Healing of Gastrointestinal Anastomoses: A Systematic Review

Transureteroureterostomy: an adjunct to the management of advanced primary and recurrent pelvic malignancy

Reinforcement of Colonic Anastomoses with a Collagenous Double-Layer Matrix Extracted from Porcine Dermis

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