Abstract
Disruption of an esophagogastric anastomosis can result in a high mortality despite aggressive treatment. The efficacy of fibrin 'glue' to seal esophagogastric anastomoses was evaluated as a means of preventing this complication. A left thoracotomy was performed in 25 adult mongrel dogs. After esophagogastric resection, a standardized esophagogastrostomy was performed and eight interrupted sutures were used to completely close the posterior wall. The anterior wall was approximated with only three sutures, leaving four large holes between sutures. The dogs were then randomized into the control group (n = 14; no attempt to seal the leaks) or into the fibrin glue-treated group (n = 11). An average of 3.3 ml of glue was applied to the anterior wall of the anastomosis in the treated group. In the control group, 13 of 14 dogs (92.9%) died of anastomotic leak a median of 3 days after operation. In the fibrin glue-treated group, only four of 11 dogs (36.4%) died of anastomotic leaks (p < 0.01). Dogs that survived were put to death at 14 days. Postmortem examination in all dogs revealed no deleterious effects or complications related to the glue. Postmortem examination of the one surviving control dog and the seven fibrin glue-treated dogs that did not die of sepsis revealed a healed anastomosis without abscess formation. We conclude that fibrin glue is effective in lessening the incidence of esophagogastric anastomotic leaks as employed in this experimental model.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 234-239 |
| Number of pages | 6 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Volume | 93 |
| Issue number | 2 |
| State | Published - 1987 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
Cite this
Esophagogastric anastomoses : The value of fibrin glue in preventing leakage. / McCarthy, P. M.; Trastek, V. F.; Schaff, Hartzell V; Weiland, L. H.; Bernatz, P. E.; Payne, W. S.; Pairolero, P. C.
In: Journal of Thoracic and Cardiovascular Surgery, Vol. 93, No. 2, 1987, p. 234-239.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Esophagogastric anastomoses
T2 - The value of fibrin glue in preventing leakage
AU - McCarthy, P. M.
AU - Trastek, V. F.
AU - Schaff, Hartzell V
AU - Weiland, L. H.
AU - Bernatz, P. E.
AU - Payne, W. S.
AU - Pairolero, P. C.
PY - 1987
Y1 - 1987
N2 - Disruption of an esophagogastric anastomosis can result in a high mortality despite aggressive treatment. The efficacy of fibrin 'glue' to seal esophagogastric anastomoses was evaluated as a means of preventing this complication. A left thoracotomy was performed in 25 adult mongrel dogs. After esophagogastric resection, a standardized esophagogastrostomy was performed and eight interrupted sutures were used to completely close the posterior wall. The anterior wall was approximated with only three sutures, leaving four large holes between sutures. The dogs were then randomized into the control group (n = 14; no attempt to seal the leaks) or into the fibrin glue-treated group (n = 11). An average of 3.3 ml of glue was applied to the anterior wall of the anastomosis in the treated group. In the control group, 13 of 14 dogs (92.9%) died of anastomotic leak a median of 3 days after operation. In the fibrin glue-treated group, only four of 11 dogs (36.4%) died of anastomotic leaks (p < 0.01). Dogs that survived were put to death at 14 days. Postmortem examination in all dogs revealed no deleterious effects or complications related to the glue. Postmortem examination of the one surviving control dog and the seven fibrin glue-treated dogs that did not die of sepsis revealed a healed anastomosis without abscess formation. We conclude that fibrin glue is effective in lessening the incidence of esophagogastric anastomotic leaks as employed in this experimental model.
AB - Disruption of an esophagogastric anastomosis can result in a high mortality despite aggressive treatment. The efficacy of fibrin 'glue' to seal esophagogastric anastomoses was evaluated as a means of preventing this complication. A left thoracotomy was performed in 25 adult mongrel dogs. After esophagogastric resection, a standardized esophagogastrostomy was performed and eight interrupted sutures were used to completely close the posterior wall. The anterior wall was approximated with only three sutures, leaving four large holes between sutures. The dogs were then randomized into the control group (n = 14; no attempt to seal the leaks) or into the fibrin glue-treated group (n = 11). An average of 3.3 ml of glue was applied to the anterior wall of the anastomosis in the treated group. In the control group, 13 of 14 dogs (92.9%) died of anastomotic leak a median of 3 days after operation. In the fibrin glue-treated group, only four of 11 dogs (36.4%) died of anastomotic leaks (p < 0.01). Dogs that survived were put to death at 14 days. Postmortem examination in all dogs revealed no deleterious effects or complications related to the glue. Postmortem examination of the one surviving control dog and the seven fibrin glue-treated dogs that did not die of sepsis revealed a healed anastomosis without abscess formation. We conclude that fibrin glue is effective in lessening the incidence of esophagogastric anastomotic leaks as employed in this experimental model.
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UR - http://www.scopus.com/inward/citedby.url?scp=0023105848&partnerID=8YFLogxK
M3 - Article
C2 - 2433550
AN - SCOPUS:0023105848
VL - 93
SP - 234
EP - 239
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 2
ER -