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Title: [Use of absorbable fibrin sealant patch to strengthen the gastrointestinal anastomosis performed on patients with peritoneal carcinomatosis treated with intention to cure by debulking surgery and intraoperative hyperthermic intraperitoneal chemotherapy].
Other Titles: Aplicación de sellante tisular como refuerzo de las anastomosis digestivas realizadas en pacientes con carcinomatosis peritoneal tratados con intención curativa mediante procedimiento quirúrgico de citorreducción y quimioterapia intraperitoneal intraoperatoria hipertérmica.
Authors: Torres-Melero, Juan
Motos-Micó, José Jacob
Lorenzo-Liñán, Miguel
Morales-González, Álvaro
Rosado-Cobián, Rafael
Keywords: Absorbable fibrin sealant patch;Anastomosis intestinal;Carcinomatosis;Cirugía citorreductora;Debulking surgery;Esponja de colágeno con fibrinógeno;Intestinal anastomosis
metadata.dc.subject.mesh: Adult
Anastomosis, Surgical
Anastomotic Leak
Biocompatible Materials
Case-Control Studies
Chemotherapy, Cancer, Regional Perfusion
Combined Modality Therapy
Cytoreduction Surgical Procedures
Fibrin Tissue Adhesive
Hyperthermia, Induced
Intraoperative Care
Middle Aged
Peritoneal Neoplasms
Prospective Studies
Issue Date: 14-Jan-2016
Abstract: Peritoneal disseminated disease, regardless of its origin, should currently be considered a locoregional disease stage, and thus a candidate for an intention to treat therapeutic option with debulking surgery and hyperthermic intraperitoneal chemotherapy. To determine whether or not the collagen sponge with fibrinogen 5.5mg and thrombin 2IU, applied as a tissue sealant and gastrointestinal reinforcement sutures, contributes to the reduction of anastomotic leak. Quasi-experimental, comparative, prospective, case/control study conducted on patients with peritoneal carcinomatosis of colorectal origin, operated on in our Peritoneal Cancer Surgery Unit from 2011 to April 2014. The study included 73 patients, 43 (59%) men and 30 (41%) women with peritoneal carcinomatosis of colorectal origin, candidates for debulking surgery and hyperthermic intraperitoneal chemotherapy. Gastrointestinal anastomoses were performed on 49 (67%) patients. These patients were randomised into 2 groups: A control (27) and B hypothesis (22) reinforced with sponge suture. The total number of anastomoses performed was 49 (mean: 1.9), with 27 in the control group A (mean: 1.88) and 22 in B (mean: 2.16). The debulkings achieved were: complete debulking 0.38 (77.5%), complete debulking 1: 7 (14.8%), and 4 (8.1%) did not undergo hyperthermic intraperitoneal chemotherapy due to complete debulking>2. Intestinal fistula: 3 cases (6.1%) in A group vs 0 in B. In our series, the use of a fibrinogen and thrombin sponge has contributed to a significant reduction in the risk of gastrointestinal fistulas in high risk oncology patients.
metadata.dc.identifier.doi: 10.1016/j.circir.2015.09.005
Appears in Collections:Producción 2020

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