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Am J Surg ; 214(5): 945-955, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28683896

RESUMO

BACKGROUND: Improved resection techniques has decreased mortality rate following liver resections(LRx). Sealants are known as effective adjuncts for haemostasis after LRx. We compared biliostatic effectiveness of two sealants in a standardized porcine model of LRx. MATERIAL AND METHODS: We accomplished left hemihepatectomy on 27 pigs. The animals were randomized in control group(n = 9) with no sealant and treatment groups (each n = 9), in which resection surfaces were covered with TachoSil® and TissuFleece®/Tissucol Duo®. After 5 days the volume of ascites(ml), bilioma and/or bile leakages and degree of intra-abdominal adhesions were analysed. RESULTS: Proportion of ascites was lower in TissuFleece/Tissucol Duo® group. The ascites volume was lower in TachoSil® group. In sealant groups, increased adhesion specially in the TachoSil® group was seen. A reduction of the "bilioma rate" was seen in sealant groups, which was significantly lower in TissuFleece®/Tissucol Duo® group. CONCLUSION: In a standardized condition sealants have a good biliostatic effect but with heterogeneous potentials. This property in combination with the cost-benefit analysis should be the focus of future prospective studies.


Assuntos
Bile , Colágeno/uso terapêutico , Adesivo Tecidual de Fibrina/uso terapêutico , Fibrinogênio/uso terapêutico , Hepatectomia , Complicações Pós-Operatórias/prevenção & controle , Tampões de Gaze Cirúrgicos , Trombina/uso terapêutico , Animais , Combinação de Medicamentos , Teste de Materiais , Modelos Animais , Distribuição Aleatória , Suínos
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