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.