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The role of tissue adhesives and sealants in colorectal anastomotic healing—a scoping review

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Abstract

Purpose

Anastomotic leakage (AL) after colorectal resection is a serious postoperative complication with grave consequences for patients. Despite several efforts to reduce its incidence, AL is still seen among 2–20% of colorectal cancer patients receiving an anastomosis. The use of tissue adhesives and sealants as an extra layer of protection around the anastomosis has shown promising results. We conducted a scoping review to provide an overview of the current knowledge on the effect of tissue adhesives and sealants on colorectal anastomosis healing, as well as their effect on the postoperative outcome.

Methods

The databases of PubMed, Embase, and Cochrane Library were systematically searched on 14/10/2022. Studies addressing the use of a tissue adhesive or tissue sealant applied around a colorectal anastomosis, with the goal to prevent AL or to decrease AL-related complications, were included. We presented an overview of the available studies and summarized their results narratively.

Results

Seven studies were included out of the 846 screened. All authors reported the rate of AL in their interventions group. Five of the studies found a decreased rate of AL compared to the control group. One study had no incidences of AL, while the last study had a seemingly low rate of AL but no comparison group. Information on secondary outcomes was sparingly reported, but the results hinted at a positive effect.

Conclusion

Tissue adhesives and sealants might have a beneficial effect on colorectal anastomosis healing. The literature is sparse, and this review has shown the need for further clinical studies.

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Data availability

All data is readily available.

References

  1. The Danish Colorectal Cancer Group (2018) Annual Review ed

  2. Sciuto A et al (2018) “Predictive factors for anastomotic leakage after laparoscopic colorectal surgery,” (in eng). World J Gastroenterol 24(21):2247–2260. https://doi.org/10.3748/wjg.v24.i21.2247

    Article  PubMed  PubMed Central  Google Scholar 

  3. Arezzo A et al (2019) “The REAL (REctal Anastomotic Leak) score for prediction of anastomotic leak after rectal cancer surgery,” (in eng). Tech Coloproctol 23(7):649–663. https://doi.org/10.1007/s10151-019-02028-4

    Article  CAS  PubMed  Google Scholar 

  4. Turrentine FE et al (2015) “Morbidity, mortality, cost, and survival estimates of gastrointestinal anastomotic leaks,” (in eng). J Am Coll Surg 220(2):195–206. https://doi.org/10.1016/j.jamcollsurg.2014.11.002

    Article  PubMed  Google Scholar 

  5. Riss S, Stremitzer S, Riss K, Mittlböck M, Bergmann M, Stift A (2011) “Pelvic organ function and quality of life after anastomotic leakage following rectal cancer surgery,” (in eng). Wien Klin Wochenschr 123(1–2):53–57. https://doi.org/10.1007/s00508-010-1514-y

    Article  PubMed  Google Scholar 

  6. Kverneng Hultberg D et al (2020) The impact of anastomotic leakage on long-term function after anterior resection for rectal cancer (in eng) Dis Colon Rectum 63(5):619–628. https://doi.org/10.1097/dcr.0000000000001613

  7. Smith JD, Paty PB, Guillem JG, Temple LK, Weiser MR, Nash GM (2012) “Anastomotic leak is not associated with oncologic outcome in patients undergoing low anterior resection for rectal cancer,” (in eng). Ann Surg 256(6):1034–1038. https://doi.org/10.1097/SLA.0b013e318257d2c1

    Article  PubMed  Google Scholar 

  8. Koedam TWA et al (2020) "Oncological outcomes after anastomotic leakage after surgery for colon or rectal cancer: increased risk of local recurrence," (in eng) Ann Surg. https://doi.org/10.1097/sla.0000000000003889

  9. Artus A et al (2020) "Long term outcome of anastomotic leakage in patients undergoing low anterior resection for rectal cancer," (in eng) BMC Cancer 20(1):780. https://doi.org/10.1186/s12885-020-07109-4

  10. Bertelsen CA, Andreasen AH, Jørgensen T, Harling H (2010) “Anastomotic leakage after anterior resection for rectal cancer: risk factors,” (in eng). Colorectal Dis 12(1):37–43. https://doi.org/10.1111/j.1463-1318.2008.01711.x

    Article  CAS  PubMed  Google Scholar 

  11. Pommergaard HC, Achiam MP, Rosenberg J (2012) “External coating of colonic anastomoses: a systematic review,” (in eng). Int J Colorectal Dis 27(10):1247–1258. https://doi.org/10.1007/s00384-012-1547-y

    Article  PubMed  Google Scholar 

  12. Sanders L, Nagatomi J (2014) “Clinical applications of surgical adhesives and sealants,” (in eng). Crit Rev Biomed Eng 42(3–4):271–292. https://doi.org/10.1615/critrevbiomedeng.2014011676

    Article  PubMed  PubMed Central  Google Scholar 

  13. Mandell SP, Gibran NS (2014) “Fibrin sealants: surgical hemostat, sealant and adhesive,” (in eng). Expert Opin Biol Ther 14(6):821–830. https://doi.org/10.1517/14712598.2014.897323

    Article  PubMed  Google Scholar 

  14. Vakalopoulos KA et al (2013) “Tissue adhesives in gastrointestinal anastomosis: a systematic review,” (in eng). J Surg Res 180(2):290–300. https://doi.org/10.1016/j.jss.2012.12.043

    Article  CAS  PubMed  Google Scholar 

  15. Duarte AP, Coelho JF, Bordado JC, Cidade MT, Gil MH (2012) Surgical adhesives: systematic review of the main types and development forecast. Prog Polym Sci 37(8):1031–1050. https://doi.org/10.1016/j.progpolymsci.2011.12.003

  16. Tricco AC et al (2018) “PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation,” (in eng). Ann Intern Med 169(7):467–473. https://doi.org/10.7326/m18-0850

    Article  PubMed  Google Scholar 

  17. VH Innovation. Covidence systematic review software  www.covidence.org (Accessed)

  18. USNL o Medicine Clinical Trials. ClinicalTrials.gov (Accessed)

  19. Pahlman L, Folkesson J, Syk I, Mangell P (2014) Initial clinical experience with lifesealTM surgical sealant in subjects undergoing low anterior resection. Colorectal Dis 16:52. https://doi.org/10.1111/codi.12710

    Article  Google Scholar 

  20. Pa˚hlman L et al (2015) Pilot study on the safety, usability and performance of lifeseal in patients undergoing an elective cicular stapled anastomosis within 10CM of the anal verge. Dis ColonRectum 58:(5)e305. https://doi.org/10.1097/01.dcr.0000464773.42498.34.

  21. Picciariello A et al (2020) Prevention of anastomotic leak in colorectal surgery by glue reinforcement. preliminary results of a prospective controlled randomized trial. Tech Coloproctol 24(4):338–339. https://doi.org/10.1007/s10151-020-02154-4

    Article  Google Scholar 

  22. Vivanco J, Ocares M, Alvarado J, Benavides C, Konig C, Caselli G (2020) Leukocyte and platelet-rich fibrin (l-prf) for anastomotic leak prevention after colorectal surgery. Tech Coloproctol 24:645. https://doi.org/10.1007/s10151-020-02193

  23. Kim HJ, Huh JW, Kim HR, Kim YJ (2014) Oncologic impact of anastomotic leakage in rectal cancer surgery according to the use of fibrin glue: case-control study using propensity score matching method. Am J Surg 207(6):840–846. https://doi.org/10.1016/j.amjsurg.2013.07.047

    Article  PubMed  Google Scholar 

  24. Shamiyeh A, Klugsberger B, Aigner C, Schimetta W, Herbst F, Dauser B (2021) Obsidian ASG® autologous platelet-rich fibrin matrix and colorectal anastomotic healing: a preliminary study. Surg Technol Int 39:147–154. https://doi.org/10.52198/21.Sti.39.Cr11508

    Article  PubMed  Google Scholar 

  25. Oliver JL, Garijo SA, Estéves MB, Ayuso MC, Fuentes FT, Gómez AC (2015) The systematic use of fibrin-based biological adhesive to prevent leakage due to healing defects in rectal anastomosis significantly reduces costs. J Surg 3(2):12–17. https://doi.org/10.11648/j.js.20150302.12

  26. Lago Oliver J et al (2012) "[Use of fibrin based biological adhesives in the prevention of anastomotic leaks in the high risk digestive tract: preliminary results of the multicentre, prospective, randomised, controlled, and simple blind phase IV clinical trial: Protissucol001]," (in spa), Cir Esp 90(10)647–55. https://doi.org/10.1016/j.ciresp.2012.05.007. Utilización de adhesivos biológicos a base de fibrina en la prevención de fugas anastomóticas en anastomosis del tubo digestivo de alto riesgo: resultados preliminares del ensayo clínico fase iv multicéntrico, prospectivo, aleatorizado y controlado simple ciego: Protissucol001

  27. Huh JW, Kim HR, Kim YJ (2010) Anastomotic leakage after laparoscopic resection of rectal cancer: the impact of fibrin glue. Am J Surg 199(4):435–441. https://doi.org/10.1016/j.amjsurg.2009.01.018

    Article  PubMed  Google Scholar 

  28. Nordentoft T, Pommergaard HC, Rosenberg J, Achiam MP (2015) “Fibrin glue does not improve healing of gastrointestinal anastomoses: a systematic review,” (in eng). Eur Surg Res 54(1–2):1–13. https://doi.org/10.1159/000366418

    Article  CAS  PubMed  Google Scholar 

  29. Panda S, Connolly MP, Ramirez MG, Beltrán de Heredia J (2020) “Costs Analysis of Fibrin Sealant for Prevention of Anastomotic Leakage in Lower Colorectal Surgery,” (in eng). Risk Manag Healthc Policy 13:5–11. https://doi.org/10.2147/rmhp.S221008

    Article  PubMed  PubMed Central  Google Scholar 

  30. Cira K et al (2022) “Coating of intestinal anastomoses for prevention of postoperative leakage: a systematic review and meta-analysis,” (in eng). Front Surg 9:882173. https://doi.org/10.3389/fsurg.2022.882173

    Article  PubMed  PubMed Central  Google Scholar 

  31. Silecchia G et al (2008) “The use of fibrin sealant to prevent major complications following laparoscopic gastric bypass: results of a multicenter, randomized trial,” (in eng). Surg Endosc 22(11):2492–2497. https://doi.org/10.1007/s00464-008-9885-0

    Article  PubMed  Google Scholar 

  32. McGuire AL, Yee J (2018) “Clinical outcomes of polymeric sealant use in pulmonary resection: a systematic review and meta-analysis of randomized controlled trials,” (in eng). J Thorac Dis 10(Suppl 32):S3728-s3739. https://doi.org/10.21037/jtd.2018.10.48

    Article  PubMed  PubMed Central  Google Scholar 

  33. Singh A, Anand S, Goel P, Yadav DK, Bajpai M (2021) “Can sealing promote healing?: a systematic review and meta-analysis highlighting the adjunctive role of tissue sealant application during urethroplasty for hypospadias,” (in eng). J Pediatr Urol 17(6):805–812. https://doi.org/10.1016/j.jpurol.2021.07.011

    Article  PubMed  Google Scholar 

  34. Investigation of the benefit of using an autologous platelet-rich fibrin matrix (Obsidian ASG®) for treatment of anastomosis during rectal surgery (ORSY) NCT05174910. Clinical Trials. https://clinicaltrials.gov/ct2/show/NCT05174910 Accessed)

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Authors and Affiliations

  1. Department of Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200, Aarhus C, Denmark

    Thomas Nikolas Valsamidis, Tine Rasmussen, Jacob Damgaard Eriksen & Lene Hjerrild Iversen

  2. Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, DK-8200, Aarhus, Denmark

    Lene Hjerrild Iversen

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  1. Thomas Nikolas Valsamidis
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  2. Tine Rasmussen
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Contributions

T.V. and L.H.I. contributed to the study conception and design. All authors contributed to acquisition, analysis and interpretation of data, and finally the writing and final revising of the article.

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Correspondence to Thomas Nikolas Valsamidis.

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Valsamidis, T.N., Rasmussen, T., Eriksen, J.D. et al. The role of tissue adhesives and sealants in colorectal anastomotic healing—a scoping review. Int J Colorectal Dis 38, 265 (2023). https://doi.org/10.1007/s00384-023-04554-y

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