Department of Surgery, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
Int J Colorectal Dis. 2012 Aug;27(8):1101-7. doi: 10.1007/s00384-012-1435-5. Epub 2012 Mar 8.
Protecting the anastomotic integrity using suture or staple line reinforcement remains an important goal for ongoing research. The present comprehensive study aims to establish the effects of fibrin glue on the early phase of anastomotic healing in the rat intestine.
One hundred and eight young adult male Wistar rats underwent resection and anastomosis of both the ileum and colon. In half, fibrin glue was applied around the anastomoses. Parameters for repair included wound strength, both bursting pressure and breaking strength at days 1, 3, and 5 after operation; hydroxyproline content; and histology, the latter also after 7 days.
A transient colonic ileus was observed in the experimental group. Anastomotic breaking strength was always similar in both the control and fibrin glue groups. Anastomotic bursting pressures remained low at days 1 and 3, without any differences between the groups. In both groups, the bursting pressure increased sharply (p < 0.001) between days 3 and 5. At day 5, the bursting pressure in the fibrin glue group remained below than that in the controls, although only significantly (p = 0.0138) so in the ileum. At day 5, but not at day 7, the wounds in the fibrin glue group contained less collagen. Other aspects of microscopic wound architecture appeared to be the same.
There is no justification for using fibrin glue on patent anastomoses constructed under low-risk conditions. Its potential benefit under conditions where chances for anastomotic leakage are enhanced needs further investigation.
使用缝线或吻合线加固来保护吻合口的完整性仍然是当前研究的重要目标。本综合研究旨在确定纤维蛋白胶对大鼠肠吻合早期愈合的影响。
108 只成年雄性 Wistar 大鼠行回肠和结肠切除吻合术。其中一半在吻合口周围应用纤维蛋白胶。修复参数包括术后第 1、3 和 5 天的伤口强度、爆裂压和断裂强度；羟脯氨酸含量；以及组织学，第 7 天也进行组织学检查。
实验组观察到短暂性结肠性回肠。吻合口断裂强度在对照组和纤维蛋白胶组始终相似。吻合口爆裂压在第 1 天和第 3 天仍然较低，两组之间没有差异。两组之间，第 3 天和第 5 天之间爆裂压急剧增加（p<0.001）。第 5 天，纤维蛋白胶组的爆裂压仍低于对照组，但仅在回肠中差异有统计学意义（p=0.0138）。第 5 天，而不是第 7 天，纤维蛋白胶组的伤口中胶原含量较少。伤口微观结构的其他方面似乎相同。
在低风险条件下构建的通畅吻合口使用纤维蛋白胶没有理由。在吻合口漏发生几率增加的情况下，其潜在益处需要进一步研究。
