{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T20:02:59Z","timestamp":1787342579199,"version":"build-2736575974"},"reference-count":29,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Anastomotic leakage (AL) remains a major complication following colorectal surgery (3\u201319% incidence, 6\u201339% mortality). SEAL-G\/SEAL-G MIST are alginate-based sealants for anastomotic reinforcement. While short-term safety and efficacy feasibility have been established in a previous study, this study reports long-term results. Methods: A multicenter, retrospective and comparative study at three centers (Israel, Italy). Retrospective Treatment group: 79 patients from the original study treated with SEAL-G\/SEAL-G MIST during elective colon cancer resection (2021\u20132023). Retrospective Control group: 86 comparative patients with standard technique. Primary endpoint: Incidence of long-term complications (adhesions, stenosis, stricture, obstruction) at 1 year. Secondary endpoints: Complications at 1\u20134 years and 30-day AL rate. Non-inferiority assessed via Farrington\u2013Manning method (margin 0.10). Results: Mean follow-up: 3.3 \u00b1 0.63 years (treatment) vs. 3.4 \u00b1 1.10 years (control). Groups were comparable for demographics and surgical characteristics. Long-term complications at 1 year: 1.27% (1\/79) vs. 2.33% (2\/86); 90% CI for difference: \u22120.067 to 0.046, p = 0.0048 (non-inferiority confirmed). No stenosis or stricture occurred in either group. No additional complications emerged at 1\u20134 years in the treatment group. Thirty-day AL rate: 1.27% (1\/79) vs. 5.68% (5\/88); all subclinical leaks (Grade B, n = 4) occurred in controls. Conclusions: Serosal reinforcement with alginate-based sealants does not introduce device-related long-term complications following colorectal anastomosis. The favorable short-term safety profile extends to 2\u20134 years. These findings support the safety of alginate-based sealants as anastomotic adjuncts, consistent with the paradigm of leak containment and severity reduction.<\/jats:p>","DOI":"10.3390\/jcm15041448","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T12:05:46Z","timestamp":1770897946000},"page":"1448","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long-Term Safety and Efficacy of Alginate-Based Serosal Reinforcement (SEAL-G\/SEAL-G MIST) Following Colorectal Anastomosis: A Multicenter, Comparative and Retrospective Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9754-5028","authenticated-orcid":false,"given":"Fahim","family":"Kanani","sequence":"first","affiliation":[{"name":"Surgical Department, Wolfson Medical Center, Holon 5822012, Israel"},{"name":"Department of Abdominal Organ Transplantation, Rabin Medical Center (Beilinson Campus), Tel Aviv University, Tel Aviv-Yafo 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1493-1768","authenticated-orcid":false,"given":"Antonino","family":"Spinelli","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy"},{"name":"IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mordechai","family":"Shimonov","sequence":"additional","affiliation":[{"name":"Surgical Department, Wolfson Medical Center, Holon 5822012, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Husam","family":"Zbede","sequence":"additional","affiliation":[{"name":"Surgical Department, Shamir Medical Center (Asaf Harofeh), Be\u2019er Ya\u2019akov 70300, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nouha","family":"Hinnawi","sequence":"additional","affiliation":[{"name":"Surgical Department, Shamir Medical Center (Asaf Harofeh), Be\u2019er Ya\u2019akov 70300, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Lavy","sequence":"additional","affiliation":[{"name":"Surgical Department, Shamir Medical Center (Asaf Harofeh), Be\u2019er Ya\u2019akov 70300, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oded","family":"Zmora","sequence":"additional","affiliation":[{"name":"Surgical Department, Shamir Medical Center (Asaf Harofeh), Be\u2019er Ya\u2019akov 70300, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moshe","family":"Kamar","sequence":"additional","affiliation":[{"name":"Surgical Department, Wolfson Medical Center, Holon 5822012, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1046\/j.0007-1323.2001.01829.x","article-title":"Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgery","volume":"88","author":"Bruce","year":"2001","journal-title":"Br. 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