Critical analysis of cyanoacrylate in intestinal and colorectal anastomosis

J Biomed Mater Res B Appl Biomater. 2014 Apr;102(3):635-42. doi: 10.1002/jbm.b.33039. Epub 2013 Oct 24.

Abstract

Background: Although cyanoacrylate glue (CA) has been widely used in various kinds of medical applications, its application in gastrointestinal anastomosis remains limited, and outcomes of experimental studies have not been satisfactory. This systematic review summarizes research regarding CA application in intestinal and colorectal anastomosis, and correlates methodological aspects to experimental outcomes.

Methods: A systematic literature search was performed using Medline, Embase, Cochrane, and Web-of-Science libraries. Articles were selected if CA was applied to intestinal or colorectal anastomoses. Included articles were categorized according to CA molecular structure; the method details in each study were extracted and analyzed.

Results: Twenty-two articles were included. More than half of the inclusions reported positive outcomes (seven articles) or neutral outcomes (eight articles). Analysis of the methods revealed that methodological details such as CA dosage, time of polymerization were not consistently reported. Porcine studies, inverted anastomosis, and n-butyl-cyanoacrylate studies showed more positive outcomes; everted anastomosis, and oversized sutures might negatively influence the outcomes.

Conclusions: Owing to the positive outcome from the porcine studies, application of CA in gastrointestinal (GI) anastomosis still seems promising. To achieve a better consistency, more methodological details need to be provided in future studies. Optimizing the dosage of CA, choice of animal model, inverted anastomosis construction, and other method details may improve intestinal and colorectal anastomoses with CA application in future studies.

Keywords: anastomotic leakage; colorectal anastomosis; cyanoacrylate; sealant; sutureless.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Anastomosis, Surgical / methods*
  • Animals
  • Biocompatible Materials* / chemistry
  • Bucrylate / chemistry
  • Colon / surgery*
  • Cyanoacrylates* / chemistry
  • Digestive System Surgical Procedures / methods*
  • Dogs
  • Enbucrilate / chemistry
  • Humans
  • Intestines / surgery*
  • Materials Testing
  • Rats
  • Rectum / surgery*
  • Tissue Adhesives*

Substances

  • Biocompatible Materials
  • Cyanoacrylates
  • Tissue Adhesives
  • poly(ethylcyanoacrylate)
  • Bucrylate
  • Enbucrilate
  • methyl 2-cyanoacrylate