Disruption of an esophagogastric anastomosis can result in a high mortality despite aggressive treatment. The efficacy of
fibrin "glue" to seal esophagogastric anastomoses was evaluated as a means of preventing this complication. A left
thoracotomy was performed in 25 adult mongrel dogs. After esophagogastric resection, a standardized esophagogastrostomy was performed and eight interrupted
sutures were used to completely close the posterior wall. The anterior wall was approximated with only three
sutures, leaving four large holes between
sutures. The dogs were then randomized into the control group (n = 14; no attempt to seal the leaks) or into the
fibrin glue-treated group (n = 11). An average of 3.3 ml of glue was applied to the anterior wall of the anastomosis in the treated group. In the control group, 13 of 14 dogs (92.9%) died of
anastomotic leak a median of 3 days after operation. In the
fibrin glue-treated group, only four of 11 dogs (36.4%) died of
anastomotic leaks (p less than 0.01). Dogs that survived were put to death at 14 days. Postmortem examination in all dogs revealed no deleterious effects or complications related to the glue. Postmortem examination of the one surviving control dog and the seven
fibrin glue-treated dogs that did not die of
sepsis revealed a healed anastomosis without
abscess formation. We conclude that
fibrin glue is effective in lessening the incidence of esophagogastric
anastomotic leaks as employed in this experimental model.