Comparative study of single-layer anastomosis in high-risk colonic anastomosis versus single layer reinforced using fibrin glue

Introduction: Complications of bowel anastomosis may be a catastrophe and devastating to the patient’s life. Reinforcing colonic wall anastomosis is of utmost importance to decrease leakage in risky colonic anastomosis. Aim: The aim of this study was to consider the efficacy of reinforcing single-layer colonic anastomosis with fibrin glue in high-risk colonic anastomosis. Patients and methods: A prospective study was conducted in Zagazig University Hospitals from December 2011 until May 2014 on 70 patients with high-risk colonic anastomosis, who were divided into two groups. Group I included 35 patients operated by means of single extramucosal bowel anastomosis and group II included 35 patients operated by means of single layer reinforced by adding fibrin glue. Results: In our study, there were 28 male and seven female patients in group I and 10 male and 25 female patients in group II. We recorded seven (20%) cases with postoperative leak; of them, five complicated to fecal fistula in group I, whereas in group II there were only three (8.5%) patients with leakage and one patient with fistula. Postoperative abscesses were 8.5% in group I and 2.9% in group II. Conclusion: Single-layer anastomosis is not enough in high-risk colonic anastomosis and needs reinforcement. Fibrin glue is widely accepted in gastrointestinal anastomosis and provides a good sealant.