Prevention of bowel surgery complications
CRC is the second most common form of cancer and the third most common cause of death from cancer in Europe. At least 50 % of the western population develop some form of CRC by the age of 70, spanning the spectrum from an early benign polyp to an invasive adenocarcinoma. Intestinal anastomosis (IA) is a surgical procedure to connect two formerly distant portions of the intestine after removal of the part affected by CRC. The most frequent and disastrous complication of IA is anastomotic leak (AL) resulting in peritonitis. AL occurs when incorrect regeneration of the intestinal tissue takes place at the site of the connection. The incidence of these post-operative complications varies from 3 to 30 %. The EU financed the three-year ANASTOMOSEAL (Development of a resorbable sealing patch for the prevention of anastomotic leakage after colorectal cancer surgical treatment) project supporting a consortium of two academia and four European industry partners. The goal of the project was the development of a biomaterial that prevents incidence of AL following surgical treatment of CRC. The objective was to produce a resorbable reinforcing medical device to adhere to the intestinal tissue that aids in rapid sealing and healing of colon-rectal anastomoses. At present, no such specific material for clinical use is available on the market. Researchers developed a bioresorbable non-toxic membrane patch using two different types of polysaccharides. Alginate provided necessary mechanical support and hyaluronan served as a bioactive material promoting tissue healing. The patch was optimised and characterised in terms of mechanical and morphological features. It could be wrapped around the IA and promoted tissue healing in an in vivo animal model. In addition, the consortium has developed an injectable solution based on a hyaluronic-acid-butyric-ester derivative that improved intestinal tissue healing in an in vivo model. The solution could also be applied in the form of enema for delivery into the internal part of the intestine. Overall, ANASTOMOSEAL successfully developed devices for CRC treatment. Preclinical tests support the conclusion that the developed devices have great commercial potential.
Keywords
Colorectal cancer, intestinal anastomosis, anastomotic leak, bioresorbable patch
