Effect of using fibrin glue to reduce the rate of anastomotic leakage in low anterior resection

Abstract

Purpose: Anastomotic leakage (AL) is a major complication occurring after low anterior resection (LAR). Several methods for anastomotic protection have been tried. However, the effectiveness of these methods at preventing AL is questioned. The present study examined whether direct application of fibrin glue to an anastomotic site could be an effective method for reducing aspects of AL, such as leakage rate. Methods: This study targeted patients who had undergone LAR between March and September 2012 for primary rectal cancer or rectosigmoid cancer which curative resection was possible. Anastomosis was performed with end to end anastomosis in all patients. Fibrin glue was used in 99 patients and conventional methods in the controls (130 patients). The research was conducted as a prospective non-randomized study. Results: AL occurred in seven cases (7.1%) in the fibrin glue group and seven cases (5.4%) in the control group; this difference wasn’t statistically significant. No significant differences were found between the two groups in terms of clinical stage of primary cancer, operation time, and length of hospital stay after surgery or in the severity of leakage or the treatment policy decisions for patients with AL. An analysis of risk factors showed that the occurrence of AL was significantly higher in male patients. Conclusion: Fibrin glue applied to an anastomotic site to prevent AL during LAR did not reduce the rate of AL. No differences were noted in other aspects of AL that would favor the use of fibrin glue over conventional methods. Keywords: Rectal cancer, Fibrin glue, Anastomotic leakage, Colorectal surgery