Human fibrinogen and thrombin patch for extraluminal protection of intestinal anastomosis

In spite of recent advances regarding equipment and surgical techniques in colorectal surgery, rates of anastomotic dehiscence (AD) have remained stable throughout the years. The development of products to protect anastomosis aiming the reduction of AD rates has shown to be promising. Human fi brinogen and thrombin patch (HFTP Tachosil®) have been used in experimental studies in animals and small case series in humans, with promising results. In this study, the authors describe the technique of HFTP use in details, aiming the protection of colorectal anastomosis, and retrospectively demonstrate the preliminary results in a pilot case series. HFTP was used in 4 patients submitted to conventional surgery. The procedures performed were: left colon resection, segmental colectomy (both for colorectal cancer), enteral anastomosis for fi stula closure and right ileocolectomy. Anastomotic healing and absence of complications were observed in 3 patients, and the patient submitted to right ileocolectomy developed AD and died after reoperation. The use of HFTP is safe and can be indicated in selected cases. However, AD can occur even after the use of this strategy. Randomized controlled trials with larger samples of patients are needed in order to properly defi ne the real benefi ts of this strategy in dehiscence prevention © 2013 Elsevier Editora Ltda. All rights reserved. * Corresponding author. E-mail: [email protected] (P.G. Kotze) 2237-9363/$ see front matter. © 2013 Elsevier Editora Ltda. All rights reserved. http://dx.doi.org/10.1016/j.jcol.2013.08.004 Membrana de fi brinogênio e trombina humanos para proteção extraluminal de anastomoses intestinais