Georgian medical news · 2026
APPLICATION OF LOCAL HEMOSTATIC AGENTS FOR STRENGTHENING THE SEAMS OF COLONIC ANASTOMOSES.
СтатьяНазвание и аннотация: Перевод в очереди
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Oklei D, Nemenko S
Аннотация
OBJECTIVE: The aim of this study was to evaluate the clinical outcomes of a combined technique using a three-row circular stapler and a collagen-fibrin patch (Tachocomb) for reinforcement of colonic anastomoses, with particular focus on the incidence of anastomotic leakage and early postoperative complications.
MATERIALS AND METHODS: A retrospective cohort analysis included 272 patients who underwent colon or rectal resection with formation of a colonic anastomosis. The control group included 173 patients (63.6%) in whom anastomosis was formed using a conventional two-row circular stapler. The experimental group included 99 patients (36.4%) in whom a three-row circular stapler was used in combination with a collagen-fibrin patch (Tachocomb). The primary outcome was the incidence of anastomotic leakage. Relative risk, absolute risk reduction, number needed to treat, and statistical significance were calculated.
RESULTS: Anastomotic leakage occurred in 9 of 173 patients in the control group (5.2%) and in 3 of 99 patients in the experimental group (3.0%). The combined technique was associated with a lower absolute rate of leakage, with a relative risk of 0.58, an absolute risk reduction of 2.2%, and a number needed to treat of 46. However, the difference between the groups was not statistically significant (p=0.55), and the 95% confidence interval for relative risk was wide (0.16-2.10). These findings indicate a favorable clinical trend but do not allow confirmation of a statistically proven advantage.
CONCLUSIONS: The combined use of a three-row circular stapler and Tachocomb was associated with a lower observed rate of colonic anastomotic leakage compared with the conventional two-row stapling technique. Nevertheless, due to the retrospective design, limited sample size, and simultaneous introduction of both components, the independent contribution of the stapler configuration and the collagen-fibrin patch cannot be determined. Further prospective randomized studies are required to verify these findings.
MATERIALS AND METHODS: A retrospective cohort analysis included 272 patients who underwent colon or rectal resection with formation of a colonic anastomosis. The control group included 173 patients (63.6%) in whom anastomosis was formed using a conventional two-row circular stapler. The experimental group included 99 patients (36.4%) in whom a three-row circular stapler was used in combination with a collagen-fibrin patch (Tachocomb). The primary outcome was the incidence of anastomotic leakage. Relative risk, absolute risk reduction, number needed to treat, and statistical significance were calculated.
RESULTS: Anastomotic leakage occurred in 9 of 173 patients in the control group (5.2%) and in 3 of 99 patients in the experimental group (3.0%). The combined technique was associated with a lower absolute rate of leakage, with a relative risk of 0.58, an absolute risk reduction of 2.2%, and a number needed to treat of 46. However, the difference between the groups was not statistically significant (p=0.55), and the 95% confidence interval for relative risk was wide (0.16-2.10). These findings indicate a favorable clinical trend but do not allow confirmation of a statistically proven advantage.
CONCLUSIONS: The combined use of a three-row circular stapler and Tachocomb was associated with a lower observed rate of colonic anastomotic leakage compared with the conventional two-row stapling technique. Nevertheless, due to the retrospective design, limited sample size, and simultaneous introduction of both components, the independent contribution of the stapler configuration and the collagen-fibrin patch cannot be determined. Further prospective randomized studies are required to verify these findings.