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Frountzas M, Pergialiotis V, Stergios K, Nikolaou C, Katafygiotis P, Lazaris AC, Schizas D, Perrea DN, Nikiteas N, Toutouzas KG. The Effect of TISSEELTM on Confined Bowel Perforation: An Experimental Study. Eur Surg Res 2021; 62:151-160. [PMID: 34139715 DOI: 10.1159/000516827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/22/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE During the last decades, surgeons of several specialties presenting different levels of expertise in colon handling have been involved in laparoscopic procedures. The aim of the present experimental study was to investigate the feasibility of TISSEELTM versus the conventional suture placement technique on confined bowel lesions in rats. METHODS Twenty-four Sprague-Dawley rats underwent confined bowel perforation and were divided into three groups: the SUTURE group (sutures were used), the SUTURE + TISSEELTM group (sutures and TISSEELTM were utilized), and the TISSEELTM group (only TISSEELTM was used). Blinded histopathologic analysis followed animal sacrifice. RESULTS The median weight of the rats was 526 ± 50 g. A single animal had hematochezia on the first postoperative day. Cessation of bleeding at the perforation margin was indicated intraoperatively after TISSEELTM application. Animals in the TISSEELTM group presented less intraperitoneal adhesions and lower hemorrhagic infiltration compared to animals of the two other groups. In addition, animals in the TISSEELTM group showed thrombus formation at the bowel perforation site compared to animals of the two other groups (p = 0.042). Histopathologic analysis demonstrated reduced inflammatory reaction (p = 0.003), diminished fibrosis (p = 0.001), and better tissue regeneration (p = 0.000) in the TISSEELTM group compared to the other two groups. CONCLUSION Application of TISSEELTM at the perforation site was associated with increased regeneration of the intestinal wall and less inflammatory and fibrotic reaction compared to suture placement. However, more experimental and clinical studies should be conducted before implementation in humans.
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Affiliation(s)
- Maximos Frountzas
- Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas," National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.,First Propaedeutic Department of Surgery, Hippocration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Vasilios Pergialiotis
- Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas," National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.,First Department of Obstetrics and Gynecology, Unit of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Konstantinos Stergios
- Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas," National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Christina Nikolaou
- Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas," National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Patroklos Katafygiotis
- First Department of Pathology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Andreas C Lazaris
- First Department of Pathology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitrios Schizas
- First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Despina N Perrea
- Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas," National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Nikolaos Nikiteas
- Second Department of Propaedeutic Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Konstantinos G Toutouzas
- First Propaedeutic Department of Surgery, Hippocration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Affiliation(s)
- Kuan-Hao Tsui
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
- Department of Pharmacy and Master Program, College of Pharmacy and Health Care, Yanpu Township, Taiwan, ROC
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Wen-Ling Lee
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC
- Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan, ROC
| | - Peng-Hui Wang
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC
- Female Cancer Foundation, Taipei, Taiwan, ROC
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