The use of a novel adhesive tissue patch as an aid to anastomotic healing
| Autor: | J Trotter, M Peter, Clare McNaught, John MacFie, K Maude, M. Gatt, L Onos |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Leak Colon Rectum Anastomotic Leak Pilot Projects Computed tomography 030230 surgery Anastomosis 03 medical and health sciences 0302 clinical medicine medicine Humans Adhesive tissue Prospective Studies Aged Aged 80 and over medicine.diagnostic_test business.industry Anastomosis Surgical General Medicine Colorectal anastomosis Middle Aged Colorectal surgery Surgery Treatment Outcome medicine.anatomical_structure 030220 oncology & carcinogenesis Abdomen Female Tissue Adhesives business Colorectal Surgery Follow-Up Studies |
| Zdroj: | The Annals of The Royal College of Surgeons of England. 100:230-234 |
| ISSN: | 1478-7083 0035-8843 |
| Popis: | Introduction One of the most feared complications of colorectal surgery is anastomotic leak. Numerous techniques have been studied in the hope of decreasing leakage. This study was designed to assess the handling characteristics of a novel adhesive tissue patch (TissuePatch™; Tissuemed, Leeds, UK) applied to colorectal anastomoses in a pilot study. This was with a view to assessing its potential role in aiding anastomotic healing in subsequent trials. Methods A patch was applied to colorectal anastomoses after the surgeon had completed the anastomosis and prior to abdominal closure. Handling characteristics and patient outcomes were recorded prospectively. Results Nine patients were recruited before the study was prematurely terminated. In one patient, the patch fell off and in another patient, the surgeon omitted to apply it. Six patients had significant postoperative problems (1 confirmed leak necessitating return to theatre and excision anastomosis, 3 suspicious of leak on computed tomography delaying discharge, 2 perianastomotic collections). One patient had an uneventful recovery. Conclusions Although the handling characteristics of this novel tissue patch were deemed satisfactory, it appears that wrapping a colorectal anastomosis with an adhesive hydrophilic patch has significant deleterious effects on anastomotic healing. This could be a consequence of the creation of a microenvironment between the patch and the anastomosis that impairs healing. Further research is required to better understand the mechanisms involved. At present, the use of such patches on colorectal anastomoses should be discouraged outside the confines of a well monitored trial. |
| Databáze: | OpenAIRE |
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