External coating of colonic anastomoses: a systematic review.

Abstract:

PURPOSE:Colon anastomotic leakage remains both a frequent and serious complication in gastrointestinal surgery. External coating of colonic anastomoses has been proposed as a means to lower the rate of this complication. The aim of this review was to evaluate existing studies on external coating of colonic anastomoses. METHODS:CINAHL, EMBASE, and PubMed were searched up to September 2011 to identify studies evaluating external coating of colonic anastomoses. RESULTS:Forty studies have evaluated 20 different coating materials, of which only fibrin sealant, omental pedicle graft, and hyaluronic acid/carboxymethylcellulose have been used in humans. Fibrin sealant has shown positive, however not significant, results. Omental pedicle graft can be used safely, yet without beneficial effects, whereas hyaluronic acid/carboxymethylcellulose should be avoided due to increased complications. The remaining coating materials have solely been evaluated in experimental animals with many contradictory and few positive results. CONCLUSIONS:External coating of colonic anastomoses has yet failed to show convincing results. Randomized clinical trials and high-quality experimental studies are warranted to determine the role of fibrin sealant, omental pedicle graft, and other coating materials for prevention of colon anastomotic leakage.

journal_name

Int J Colorectal Dis

authors

Pommergaard HC,Achiam MP,Rosenberg J

doi

10.1007/s00384-012-1547-y

subject

Has Abstract

pub_date

2012-10-01 00:00:00

pages

1247-58

issue

10

eissn

0179-1958

issn

1432-1262

journal_volume

27

pub_type

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