Suture-free anastomosis of the colon. Experimental comparison of two cyanoacrylate adhesives.

BACKGROUND

We explored the potential of two cyanoacrylate tissue adhesives for constructing colonic anastomoses.

METHOD: The study involved 12 female domestic pigs. The animals were divided into two equal groups. In both groups, the sigmoid colon was transected. An intestinal anastomosis was constructed with a modified circular stapler (all staples were withdrawn) and cyanoacrylate tissue adhesives. Glubran 2 was used in group A and Dermabond was applied in group B. Fourteen days after the first operation, a follow-up surgery was performed in both groups. The glued section of the colon was resected, processed with the standard paraffin technique and stained with haematoxylin-eosin. The finished specimens were examined under light microscopy. Assessments were made for the presence of fibroblasts, neutrophils, giant polynuclear cells, neovascularisation and collagen deposits. Adhesions, anastomotic dehiscence, peri-anastomotic inflammation and intestinal healing were assessed peri-operatively.

RESULTS

All anastomoses in group A healed with no signs of pathology. In group B, fibrotic adhesions and stenoses tended to occur in areas surrounding the anastomoses. Histological examinations confirmed increased fibrosis.

CONCLUSION

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.