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Effect of fibrin sealant on perianastomotic tumor growth in an experimental model of colorectal cancer surgery

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

Viable intraluminal tumor cells can penetrate a clinically intact rodent colonic anastomosis and give rise to perianastomotic tumor growth. The aim of this study was to determine whether transanastomotic cell migration can be prevented by fibrin-based tissue sealant. Following distal colonic transection and reanastomosis with 5/0 silk sutures, Fischer F344 rats were randomly allocated to three experimental groups. In Group A, a circumferential ring of tissue sealant was placed around the serosal surface of the anastomosis; in Group B, sealant was limited to 50 percent of the anastomotic circumference; and, in Group C, no sealant was applied. All rats then had 10 5 Mtln 3 carcinoma cells injected into the proximal colonic lumen via a rectal catheter. The incidence of perianastomotic tumor at 21 days was significantly lower in Group A (3 of 14 animals) than in Group B (11 of 16 rats) (P =0.012; Fisher's exact test) or Group C (10 of 14 rats;P=0.011). A further experiment demonstrated that sealant did not protect the anastomosis when tumor cells were instilled directly into the peritoneal cavity. A topical carcinocidal action therefore appears unlikely, but our results suggest that a circumferential anastomotic ring of fibrin sealant forms an effective mechanical barrier preventing intraluminal tumor cells from reaching the peritoneal cavity.

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Authors and Affiliations

  1. Lecturer in Surgery, University Department of Surgery, Western Infirmary, G11 6NT, Glasgow, UK

    J. R. McGregor M.D., F.R.C.S., D. H. Reinbach F.R.C.S. & P. J. O'Dwyer M.Ch., F.R.C.S.I.

  2. University Departments of Pathology, Western Infirmary, Glasgow, UK

    S. W. Dahill B.Sc., M.B. Ch.B.

Authors
  1. J. R. McGregor M.D., F.R.C.S.
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  2. D. H. Reinbach F.R.C.S.
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  3. S. W. Dahill B.Sc., M.B. Ch.B.
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  4. P. J. O'Dwyer M.Ch., F.R.C.S.I.
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Supported by a grant from the Research Support Group of the Greater Glasgow Health Board.

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McGregor, J.R., Reinbach, D.H., Dahill, S.W. et al. Effect of fibrin sealant on perianastomotic tumor growth in an experimental model of colorectal cancer surgery. Dis Colon Rectum 36, 834–839 (1993). https://doi.org/10.1007/BF02047379

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