Use of Tachosil® in bariatric surgery: preliminary experience in control of bleeding after sleeve gastrectomy

Abstract

Aim: Laparoscopic sleeve gastrectomy (LSG) is one of the most common procedures of bariatric surgery. Nevertheless complications after LSG are common, the most frequent is bleeding. Our purpose was to reduce bleeding after gastric resection, thus reducing the risk of anemia.

Methods: The study took part in our Multidisciplinary Obesity Treatment Centre, between May 2008 and January 2010. Thirty patients were candidates to SG. They were enrolled in this prospective, parallel group, single-blind randomized trial, to proof the effectiveness and safety of the use of hemostatic-sealant drug Tachosil® as a reinforcement of the suture line in sleeve gastrectomy. Patients were enrolled in Group A when TachoSil® was used and Group B if not. We collected data about weight loss every month, RBC, Hb, PLT, ESR, CRP, WBC in the first week daily and at 2, 4 and 6 months on follow-up.

Results: Two groups did not significantly differ for mean age, mean of body weight (118.5 vs. 121.9 kg), BMI (48.4 vs. 49.6 kg/m2), operation time (108 vs. 102 min), hospitalization duration (6.5 vs. 7 days). In group B mean drainage fluid collection was 120, 80 and 60 mL on 1st, 2nd and 3rd postoperative day. Tube removal occurred on average on 5th postoperaive day. In group A (no drainage) control echogram ruled out any fluid collection. RBC, Hb and PLT decreased from 2nd postoperative day. Decrease of PLT was non-significantly different. Decrease of RBC and Hb was significantly different (-0.4 x 106/mL vs. -1.7 x 106/mL; -0.5 g/dL vs. -1.2 g/dL). All other values were not different between groups.

Conclusion: In this prospective experience the hemostatic-sealant drug Tachosil®, that contains a collagen sponge coated by human fibrinogen and thrombin was shown to reduce post-operatory bleeding and probably promote optimal wound healing.