Suture-Free Anastomosis of the Colon Experimental Comparison of Two Cyanoacrylate Adhesives

Abstract

The tissue adhesive Glubran 2 appears to be (under experimental conditions) a promising synthetic adhesive for colonic anastomosis construction; conversely, the tissue adhesive Dermabond was unsuitable for suture-free anastomosis construction.

Reducing Anastomotic Leakage by Reinforcement of Colorectal Anastomosis with Cyanoacrylate Glue

“…Besides CA dosage, inversion of a gastrointestinal anastomosis has been considered as a key factor in anastomotic healing [22], and was also essential to the reinforcement technique discussed in this study. Some previous studies reported a leakage rate of 34% in everting CA-sealed anastomoses [23,24], while in another study, no leakage and good wound healing were found when a modified circular stapler was used to create inverted anastomoses sealed with CA [13]. These aspects and other technical details of CA's application should also be taken into consideration for AL studies.…”

“…It has been shown to provide strong mechanical attachment and polymerize quickly within 30-60 s after application [11]. Clinical practice showed promising results on the use of CA as a sealant after primary anastomosis in pancreaticoduodenectomy [12]; experimental studies also used CA to create sutureless colorectal anastomoses [13]. These results suggested that CA seemed to be a promising alternative to supportive sutures in low colorectal anastomosis.…”

Critical analysis of cyanoacrylate in intestinal and colorectal anastomosis

“…Nine studies regarding NBCA were included (Table II). Among these, three studies focused on the sutureless anastomosis, three studies looked into NBCA sealant, and the other three tested both applications . In the NBCA studies, all four large animal studies had positive results, whereas of the other five rat studies only one had positive outcomes …”

“…Only NBCA showed good wound healing without stenosis after 4 or 12 weeks . Another comparison between NBCA (Glubran 2) and OCA (Dermabond) was performed in a porcine model . The CA sutureless anastomoses were constructed in the colorectum with a modified stapling device in which all the staples were taken out in advance.…”

“…Although substantial experimental efforts have been made, the results of animal studies have not yet been encouraging. Some experimental studies reported anastomoses could be well constructed with CA; whereas others reported a mortality rate as high as 30–40% . Besides large variations in results, inconsistencies with regard to the methodology were also noticed in those experiments.…”